Insulin Resistance

What is Insulin Resistance?

Insulin is a hormone that plays a dominant role in regulating various metabolic processes including blood sugar and body fat percentage. Under normal circumstances, this process is highly dynamic and constantly fine-tuned by the body. However, under certain conditions, the body becomes blunted to the regulatory effects of insulin. When this happens, the normal mechanism starts to fail and ‘insulin resistance’ sets in. As a result, blood sugar levels start to climb.

To compensate the body increases its production of insulin, thereby causing insulin levels to rise. When it comes to regulating blood sugar, rising insulin levels are beneficial since it helps keep rising blood sugar under control. However, when it comes to regulating body fat percentage, rising insulin levels spell somewhat of a disaster. This is because the hormone insulin not only makes the body more effective at storing fat but also makes it more difficult to burn fat.

The net effect is that your metabolism effectively slows down.

How is metabolism regulated?

All biochemical processes that take place in the body are initiated and controlled by a complex communication system that relies on messenger molecules that are able to convey biochemical instructions. Examples of messenger molecules are hormones, neurotransmitters and cytokines. Chemicals contained within pharmaceutical drugs or medicinal plant extracts also achieve their results through the same mechanism.

Depending on their design, messenger molecules deliver their biochemical communication either broadly at a high level to a large audience, or more selectively at a local level in a more specific manner. They can also override or overrule each other, as well as strengthen or amplify another’s message.

Metabolism is a complex process which involves the regulatory activity of various different messenger molecules. It is commonly believed that the thyroid gland is in charge of this process. This misguided view is based on oversimplification, since the numerous regulatory tasks that insulin performs relating to carbohydrate, protein and fat metabolism, as well as how insulin overrules virtually all other messenger molecules involved in the process, makes insulin the single most dominant controller of metabolism.

What causes insulin resistance?

Whilst genetic makeup, increasing age and certain disease states make you more prone to developing insulin resistance, lifestyle factors that lead to weight gain and the ultimate triggers. These include diet and a sedentary lifestyle. At the heart of the problem is excess body fat, not because of the space that it consumes within the body, but because excess body fat starts to release a range of messenger molecules that not only initiates a pathological communication process within fatty tissue itself but as a secondary consequence, spreads a message that usually results in disease to the rest of the body.

Why excess body fat causes insulin resistance

Two major mechanisms contribute towards weight gain. Not only do existing fat cells increase their fat content, but new fat cells are continuously being formed through a proliferation process. Individually, newly formed fat cells also start accumulating fat which collectively leads to accelerated weight-gain and the progressive enlargement of the total fat mass. In a more advanced state, this process leads to the distortion of fatty tissue, commonly referred to as cellulite.

In the past, fat cells were accredited with only two main functions, namely that of storing calories for later use and preserving body temperature via improved insulation. However, in the presence of excess body fat, fat cells also assume a new biochemical communication function by starting to manufacture various messenger molecules including ‘adipokines’ and ‘inflammatory cytokines’. These have an effect on many different tissue types and tend to interfere with the normal chemical function of the body. For reasons not completely understood, some inflammatory cytokines disrupt insulin’s role on a cellular level when it comes to regulating blood sugar, leading to type 2 diabetes.

Adipokines, on the other hand, initiate the process of new fat cell formation called ‘adipogenesis’. In reality, by releasing adipokines and inflammatory cytokines, fat cells, in essence, become an endocrine organ which starts to function independently from the body. A vicious cycle ensues during which you become physiologically and biochemically altered, and you are virtually held hostage by your own abnormal fatty tissue.

Blocking the communication process between fat cells at a cellular level, especially when it comes to the formation of new fat cells and the development of insulin resistance, has, therefore, become a modern therapeutic focus.

Why elevated insulin levels cause weight gain

Insulin performs several different functions that may lead to the accumulation of excess body fat. Firstly, insulin regulates fat production. After a meal, when the quantity of glucose that enters the system is more than what can be used for immediate energy requirements, insulin promotes the conversion of excess sugar into fatty acids. These are subsequently grouped as larger molecules called triglycerides and transported to the fatty tissue where they are stored.

In the body, fat cells represent the ultimate energy store room. Starting life as a miniature pantry, these unique storage containers can rapidly expand in size to fulfil the role of a massive warehouse. Within the environment of fat cells, insulin fulfils the role of storeroom manager. By design, insulin’s tasks are to firstly fill each warehouse to maximum capacity and then secondly, to keep stock levels as high as possible by actively preventing fat from leaving.

Inside a fat cell, however, another messenger molecule called ‘hormone-sensitive lipase’ (HSL) plays an opposing role to insulin. Acting as the dispatch manager of the warehouse, HSL has the sole task of releasing as much fat from the fat cell as possible so that it can be shipped off to fuel the metabolic furnace. In the presence of insulin, however, this biochemical function is overruled and fat effectively stays trapped inside fat cells. Only once insulin levels drop can HSL perform its duty by mobilising and releasing fat from the warehouse.

The bottom line is that insulin not only helps you to gain weight but when levels are chronically elevated as in the presence of insulin resistance, it also makes it more difficult for you to lose weight.

The medical consequences of insulin resistance

Doctors deal with the complications of insulin’s obesity-promoting tendency on a daily basis. Whilst insulin is the critical regulator of blood sugar control, increased insulin levels may also lead to weight gain. In fact, these effects can be rather counterproductive when treating an overweight diabetic patient.

Various studies have confirmed the role that insulin plays in weight gain. This includes data obtained from two landmark studies; the UKPDS (United Kingdom Prospective Diabetes Study) and DCCT (Diabetes Control and Complication Trial). The most obvious example, however, can be seen in someone who develops an insulinoma, a rare tumour of the pancreas that secretes insulin. Besides developing low blood sugar, individuals with insulinomas also gain weight at an alarming rate and can become massively obese in a very short period of time.

In the presence of insulin resistance, limiting insulin-associated weight gain through an insulin sparing mechanism has, therefore, become a novel therapeutic target.

How is insulin resistance diagnosed?

In clinical practice, a combination of fasting insulin and glucose levels are used. These are calculated according to the HOMA (Homeostatic Model Assessment) or QUICKI (quantitative insulin sensitivity check index) method.  In specialised medical research, however, a more accurate technique called the ‘hyperinsulinemic euglycemic clamp’ is used. Research has shown that results from the HOMA and QUICKI correlate reasonably well with clamping studies regarding accuracy.

Although less precise, a more simple way to predict insulin resistance is to measure your waist circumference. According to American guidelines, males with a waistline measurement of more than 90cm and females measuring more than 80cm will be significantly more inclined towards insulin resistance. European guidelines differ slightly from American guidelines, with 93cm for males and 79cm for females being the upper range of normal.

Research suggests that these waist circumference guidelines may be set too high for black South African men, and an even lower cutoff measurement may be more accurate for diagnosing insulin resistance. However, more research is required to confirm this.

How is insulin resistance linked to type 2 diabetes?

Since some of the inflammatory cytokines that fat cells start releasing disrupt insulin’s role on a cellular level when it comes to regulating blood sugar, insulin resistance is one of the leading causes of type 2 diabetes. This escalating process, however, may also fuel a vicious cycle of increased levels of insulin resistance and as a consequence, a greater requirement for insulin, thereby posing the threat of gaining even more weight. Whilst optimal glycemic control is essential to good health, weight gain is also known to accelerate some of the other disease processes associated with the metabolic syndrome, thereby potentially undermining the metabolic and cardiovascular benefits of optimal blood glucose control.

What is the link between insulin resistance and inflammation?

Excess body fat leads to the release of various inflammatory cytokines. In type 2 diabetics, insulin resistance is associated with low-grade chronic inflammation. Since this process is a known risk to develop blood clots in the presence of hardening of the arteries, it is often used to explain some of the microvascular complications that occur in type 2 diabetes. However, there is also significant evidence to suggest that even before the clinical diagnosis of type 2 diabetes is made, those with excess body fat have an increased risk of cardiovascular disease and vascular thrombosis because of low-grade inflammation.

What is the link between insulin resistance and PCOS?

Besides playing the dominant role in metabolism, insulin has a number of other hormonal effects including the regulation of normal ovarian function and influencing a number of male hormones present in females. Increased levels of insulin, as caused by insulin resistance, causes a reduction in a hormone called sex hormone-binding globulin (SHBG) in the liver. This results in abnormally high levels of male hormones in women.

What is the link between insulin resistance and stress?

Various hormones are influenced by stress, especially cortisol, which has been implicated in the development of insulin resistance.  It is also known that insulin resistance and the various inflammatory cytokines that are released by the fat cells during the process can result in far reaching biochemical consequences.  These are known to have a negative impact on brain function, leading to concentration and mental processing problems, irritability and mood disorders, including depression, sleep disorders and dementia.

Cholesterol

What is cholesterol?

Cholesterol is a naturally occurring, waxy substance, with many vital roles in the body. These include the synthesis of certain hormones, vitamin D, digestive aids, and forming part of cell membranes. 

Collectively, cholesterol and other fats in your blood (known as triglycerides) are called lipids. Each performs unique biological roles and contributes differently to your risk for disease. While there are many medical terms that describe various types of cholesterol abnormalities, the one most commonly used is dyslipidaemia.

Why is high cholesterol dangerous?

High cholesterol can double your risk of cardiovascular disease (CVD) by contributing to atherosclerosis, a build-up of plaques within your arteries. These plaques are made up of excess cholesterol together with fat, calcium, and other substances. Plaques contribute to CVD in a variety of ways, including reducing blood flow to various parts of the body, making the heart work harder and decreasing oxygen supply to tissue. 

Enlarged plaques may entirely block an artery, stopping oxygen supply and resulting in the death of the affected muscle or tissue as in the case of a heart attack or stroke. Partial blockage to the heart muscle can cause chest pains (angina) that may also be felt in the neck, shoulders, arms, jaw, or back.

Both heart attack and stroke are life-threatening, and everyone should be aware of their symptoms, as rapid treatment is necessary. Refer to our later section for these symptoms.

Atherosclerosis is known as a silent killer because it causes few or no symptoms, explaining why high cholesterol is often only diagnosed when a major cardiovascular event, such as a heart attack, occurs. Regular check-ups are therefore important – even if you live a healthy life. 

What is the difference between ‘good’ and ‘bad’ cholesterol?

Cholesterol is insoluble in blood and must be transported around the body by special molecules called lipoproteins. The two most well-known ‘types’ of cholesterol are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL cholesterol tends to accumulate within arterial walls, which is why it is often referred to as ‘bad’ cholesterol. HDL cholesterol is more efficiently transported to the liver and excreted, and may even help to remove LDL cholesterol from the arteries, helping to lower cholesterol levels. This is why it is often referred to as ‘good’ cholesterol.

What are triglycerides (TGs)?

Most fat in the body exists as triglycerides (TGs). They can be stored (increasing your weight), but a large proportion circulate in the blood stream, transporting fat to various parts of the body. TGs may be formed from fat or carbohydrate, explaining why a high carbohydrate diet is in many cases as detrimental as a high fat diet. A raised TG level is a major risk factor for atherosclerosis and CVD, and could also indicate the presence of other disease conditions, including insulin resistance, diabetes and liver disease.

What causes high cholesterol?

Cholesterol levels are affected by numerous factors.  Some are related to an unhealthy lifestyle, but others may result from genetics, increasing age, or other diseases. Atherosclerosis can begin in childhood and risk factors should be managed from an early age. The likelihood of CVD increases with an increase in risk factors.

Lifestyle factors that can contribute to CVD include poor diet, lack of exercise, tobacco, alcohol, certain drugs and even stress. These are generally within our control and are therefore known as modifiable risk factors.

Non-lifestyle factors are termed non-modifiable as they are beyond our control. These include:

  • Pre-existing disease: metabolic syndrome, insulin resistance, diabetes, thyroid disorders and kidney disease.
  • Genetics and family history: South Africa has one of the highest incidences of familial hypercholesterolaemia in the world, and in some communities can affect as many as 1 in 75 people. A family history of heart disease also increases the risk of CVD.
  • Gender: although woman often consider CVD a man’s disease, deaths caused by CVD are second only to HIV/AIDS for both genders.
  • Age: cholesterol levels generally increase with age. This is especially true for post-menopausal woman.
  • Cholesterol recycling efficiency: the body recycles cholesterol through the liver via bile. This is transported to the intestines, where up to half is reabsorbed. A high reabsorption rate will result in increased cholesterol levels.
  • Psychological issues: conditions such as chronic stress, depression, anxiety, and schizophrenia have been associated with increased risk for CVD and dyslipidaemia.

What are the symptoms of a heart attack or stroke?

Rapid intervention decreases the risk of permanent damage, disability and/or death. Seek immediate medical attention if you notice any of the following symptoms in yourself or those around you, especially if they occur in combination. 

Symptoms of a heart attack include pain or discomfort, especially in the left or centre of the chest, upper parts of the body such as the arms, back, neck, jaw, or stomach, shortness of breath, cold sweat, nausea or light headedness.

Symptoms of a stroke include sudden numbness in the face, arms, or legs. This is especially diagnostic if the numbness is confined to one side of the body. Other symptoms include severe headaches, confusion, dizziness, loss of balance and difficulty seeing with one or both eyes.

When should I find out what my cholesterol levels are?

Due to the high presence of familial hypercholesterolemia in South Africa, it is important that people are tested from an early age. Healthy people over the age of 20 should test their cholesterol levels at least every four to six years. More frequent testing should be done as you age, if you are overweight, practice an unhealthy lifestyle, or have a family history of CVD. The sooner dyslipidemia is diagnosed and treated, the lower your risk of CVD in the future. So whether you are young or old, thin or fat, man or woman, you should know your blood cholesterol levels. 

How do I get my cholesterol level tested, and what do the results mean?

Preliminary screening for cholesterol abnormalities can be done in a point-of-care environment using a finger prick blood sample, which measures total cholesterol. Select clinics now also offer lipogram screenings which measure the different types of cholesterol and TGs. Although total cholesterol can give you an indication of your risk, a full lipogram is important to accurately test your CVD risk and plan an effective intervention strategy. While it is usually required that you fast for 9 hours before doing the test, recent research has suggested that this is not actually necessary. 

Cholesterol target levels are based on an individual’s CVD risk, which is calculated according to the presence of the previously mentioned risk factors.

How do I lower my cholesterol?

Lifestyle changes are an important strategy to reduce your risk for CVD, even if you take cholesterol-lowering medication. An early, proactive approach may slow, reduce, or even reverse arterial plaque build-up, thereby further reducing your risk for CVD. These strategies may also prevent the development of other conditions such as metabolic syndrome and cancer. 

According to The World Health Organisation (WHO), a 10% reduction in total cholesterol may halve the risk of CVD, and each mmol/L reduction in LDL-C shows a significant reduction in CV related death and disability and is therefore a goal of treatment. 

General guidelines for lowering your cholesterol and reducing your risk of CVD are:

1. Eat a healthy diet

Diet is a significant risk factors in a wide range of diseases. Download a free copy of our Cholesterol-modifying dietary guidelines here.

In order to stick to a heathy diet, you should:

Know your fats

Dietary fat intake is one of the most significant contributors to dyslipidemia. 

Avoid saturated and trans-fats as well as foods high in cholesterol. Saturated fats include animal fats, especially red meat and dairy, and some plant based fats like coconut and palm oil. Many vegetable oils, fried and processed foods, such as french fries, pies, and fast food are also high in trans-fats. 

Poly- and mono-unsaturated fats may be able to reduce your total cholesterol levels. These fats come from plant-based foods, such as olive oil, flax seed oil, avocados and nuts, and extend to fatty fish like salmon, sardines, and mackerel. Many of these are also high in Omega 3 fatty acids, which may improve your lipid profile. 

Read food labels

Just because a product is labelled as “low fat”, does not mean that it is healthy. If a food item claims to have no trans-fat, check the ingredients list for hydrogenated or partially hydrogenated vegetable oil, which is just a different name for the same thing. Many low fat foods are also high in sugar, which can be just as detrimental. Excessive amounts of salt can also increase CVD risk.

Avoid diets high in carbohydrates, especially those with a high glycaemic index

Reducing total saturated fat content in your diet is important, but replacing these calories with carbohydrate has been shown to have little to no benefit in terms of cardiovascular health, and is more likely to lead to other conditions such as diabetes and obesity. This is especially true for refined carbohydrates and sugar which may also have an adverse effect on TG levels. Rather replace these calories with healthy fats and protein, and where carbohydrate is used, make sure it is low GI and whole grain.

Eat a diet high in natural, plant based foods

Plants have a wide variety of health benefits. Not only are they a rich source of vitamins and minerals, but they also contain numerous molecules which can help to manage cholesterol and CVD, including polyphenols, fibre, and phytosterols, all of which have been shown to lower cholesterol and the risk for CVD. For example, a diet high in fibre can reduce your cholesterol levels by up to 10%. 

In order to maximise the benefit you get from eating plants, make sure that they are raw, or only lightly cooked, and unpeeled where possible, as many of their beneficial compounds can be broken down by heat and occur in the coloured parts or skins of fruits.

It is suggested that at least 5 servings of vegetables and fruit are eaten per day. Despite the health benefits of fruit, they are also high in sugar, and so should not be eaten excessively.

2. Exercise, remain active, and reduce your weight

Exercise and maintaining an active lifestyle are extremely important in all aspects of your health. Physical activity lowers LDL-C, raises HDL-C, improves heart fitness, and other metabolic parameters which reduce your CVD risk. Movement in general is also important, as long periods of inactivity can be just as dangerous as no exercise at all. It is recommended that adults accumulate at least two and a half hours of moderate intensity exercise per week, while children and adolescents get at least an hour a day, and that bouts of inactivity are broken up by movement at least once every hour.

Excess weight is extremely dangerous and adds to your risk for numerous diseases, including insulin resistance, metabolic syndrome, cancer and CVD. Achieving and maintaining a healthy weight may help to lower LDL-C and TG levels, as well as increase HDL-C. A waist circumference over 102cm (men) and 88cm (woman) increases the risk for a wide range of diseases, independent of weight.

3. Stop unhealthy habits

This is especially true in the case of smoking. If you are a smoker, you should quit immediately, and if you are not, avoid any exposure to second hand smoke. Excessive alcohol consumption has also been linked to CVD. Alcohol intake should be limited to no more than two units per day for men and one for woman (1 Unit = 120 ml Wine, 50 ml Dessert wine, 200 ml Beer, 280 ml Lite Beer, 1 Tot  Distilled Liquor, 20 ml Cream-Based liqueur). 

4. Consult your doctor and remain aware of any other medical or psychological conditions you might have

Treatment and prevention strategies depend on your specific lipid profile and risk factors. Working with your doctor will help provide the optimal solution with regard to your unique lifestyle and risk factors.

In many cases, lifestyle changes alone are not sufficient, and medication may be required. There are a variety of cholesterol-lowering medications available, the most common is a group of drugs known as statins. Each type has been shown to improve cholesterol levels and decrease the risk of heart disease. Cholesterol-lowering drugs have a number of side effects and can interact with other medications and medical conditions, requiring close monitoring by a medical professional. For this reason, they are usually only prescribed in high-risk cases where cholesterol levels become unmanageable or where cardiovascular disease is already present.

5. The role of RyChol

Plant-based ingredients have also been shown to lower lipid levels significantly. RyChol, from the Medical Nutritional Institute (MNI), has been developed to combat high cholesterol.

What does RyChol do?

Independent research has shown that RyChol’s unique blend may help to stabilise blood cholesterol and triglyceride levels by targeting multiple biological pathways.

What does RyChol contain?

RyChol contains a blend of plant-derived (phytochemical) ingredients that have each been recognised to help reduce blood cholesterol levels in a unique and individual manner. Its multi-modal pharmaceutical action is achieved through the selective inhibition of various biochemical pathways involved in saturated fat digestion, cholesterol absorption, as well as cholesterol excretion. The ingredients contained in RyChol are plant-sterols, apple polyphenols, barberry root extract and coenzyme Q10.

  1. Plant- or phytosterols are naturally occurring plant fats that are structurally similar to cholesterol and compete with cholesterol absorbtion in the intestines.
  2. Apples contain several biologically active polyphenols that include the flavonoids and phenolic acids that have been shown to help inhibit the digestion of saturated fat in the digestive tract, thereby helping to reduce the absorption of fat (triglycerides).
  3. Coenzyme Q10 is a fat-soluble anti-oxidant found in meat, fish and dairy, and to a lesser degree, in grains, nuts and certain plants. It is present in most cells, primarily in the mitochondria, where it plays a critical role in ATP production, the body’s most basic energy unit.
  4. Barberry root extract contains a botanical chemical called berberine that is naturally found in the roots, stems and bark of various plants. Berberine has been demonstrated to lower cholesterol levels by increasing cholesterol clearance through the liver. This is achieved through a process called ‘up-regulation’ whereby increased numbers of liver LDL receptors are produced, thereby leading to the accelerated clearance of LDL cholesterol from the system.

Who may benefit from taking RyChol?

RyChol can be used by individuals with a high blood cholesterol level before prescription medication is required. RyChol can be used in combination with most cholesterol-lowering drugs where indicated. Response to treatment is largely determined by good compliance such as ensuring you take the correct dose every day. Check your cholesterol profile after 12 weeks of treatment. As raised cholesterol tends to be a chronic condition, continued use of RyChol may be required.

Medication does not negate the need for a healthy lifestyle. Addressing lifestyle factors efficiently will ensure that you take the lowest dose possible, and that your disease risk is lowered in many other ways too. 

Can RyChol be used in conjunction with statins?

Yes, trials done on some of the individual ingredients contained within RyChol, such as phytosterols and berberine, have indicated favourable results when used in conjunction with statins.

What role does MNI play?

1. Products

MNI has developed several natural, plant-based products which aid in combatting risk factors associated with cardiovascular disease (CVD). These can be used individually or in combination with most prescription medications or each other.

  • RyChol extended-release formulation contains a unique blend of plant-derived phytochemical ingredients known to reduce blood cholesterol, triglyceride, and LDL levels.  This unique combination supports multiple pathways involved in the digestion, absorption and clearance of cholesterol and the other detrimental fats from the system.
  • AntaGolin contains a blend of plant-derived phytochemical ingredients that combats insulin resistance and optimises blood-sugar metabolism. This unique combination supports multiple pathways involved in the input, output and processing of sugars in the body and the optimal regulation of metabolism.  
  • NeuroVance contains a blend of plant-derived phytochemical ingredients that optimise and support healthy brain function by giving your brain a physiological advantage during times of stress without acting as a sedative or stimulant.
  • NeuroVance Focus is a unique blend of plant-derived phytochemical ingredients, vitamins and minerals that optimises your child’s general health by targeting multiple neurological and immunological functions simultaneously.
  • RheumaLin contains a unique blend of plant-derived phytochemical ingredients that targets the enzymes that cause the inflammation and optimises joint preservation.
  • FlamLeve is a natural anti-inflammatory product that combats inflammatory pain and protects the body against the harmful effects of inflammation.  This unique combination of plant-derived phytochemical ingredients ensures superior absorption and bioavailability, making FlamLeve 500 times more potent than standard turmeric.

2.  Meal plans

Our insulin-friendly (C.A.P.E) meal plan, designed specifically to combat insulin resistance and obesity which are both significant contributors to CVD, can also be applied to cholesterol reduction as unhealthy fats are reduced and healthy fats increased. Download your free copy here.

3.  Online information and resources

MNI provides information and training to healthcare practitioners and a number of free information resources to the public, increasing awareness of the most important diseases you or your family might face. 

4.  MyMNI

MNI recognises that individuals react differently to lifestyle, disease conditions and their response to intervention strategies. You can get more information from the Frequently Asked Questions sections on our website or email us at expert@mnilifestyle.co.za

5.  Loyalty reward program

In line with our goal to aid you in managing your risk for various chronic diseases and assist in compliance, MNI offers a FREE MNI product for every 5 of the same MNI products purchased. 

To qualify for your free MNI product, all you need to do is send the slips of your 5 MNI products together to loyalty@mnilifestyle.co.za. Read more about our Loyalty Program here.

Sources:

  1. http://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html
  2. http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp#.V6sVA_l97Z4
  3. http://www.heartfoundation.co.za/
  4. http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/ Global Health Observatory (GHO) data
  5. South African Dyslipidaemia Guideline Consensus Statement: A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA) South African Family Practice 2015; 57(2):22-31

Stress

What is stress?

Stress is the body’s response to a change that requires a physical, mental or emotional adjustment. It is also the body’s method of reacting to or preparing for a new challenge. Stress can originate from any situation or thought that makes you feel concerned, nervous, frustrated or angry. Its effects on the body are not only psychological, but physiological as well.

The physiological reaction that occurs in response to a perceived threat happens via activation of the sympathetic nervous system. This results in a typical ‘fight-or-flight’ response. Besides the nervous system, various stress hormones are also released into the body. The immediate response is activated by the hormones such as adrenaline (epinephrine) and noradrenaline (norepinephrine), whilst cortisol controls the more long-term stress response.

What is cortisol?

Cortisol is a steroid hormone produced by the adrenal glands. Cortisol plays an important role in how the body uses food substrates such as carbohydrate, fat, or protein, in order to meet additional physiological demands. Cortisol is normally released in response to events such as waking up in the morning, during physical exercise and stressful events.

When chronically elevated, cortisol has a negative impact on many systems, including weight control and immune function. With a high stress, fast-paced lifestyle, the body ends up producing cortisol almost continuously. Whilst cortisol is essential to the body, too much cortisol can have a significantly detrimental effect on our health.

What effect does stress have on blood sugar levels and the development of diabetes?

Under stressful conditions, cortisol helps to provide the body with glucose by tapping into protein stores and helping to release the glucose that is stored in the liver. This energy is required in a typical fight-or-flight situation. However, elevated cortisol over the long term constantly stimulates the release of glucose, leading to increased blood sugar levels. Since a principal function of cortisol is to counteract the effects of insulin, it causes bodily cells to become insulin resistant. Over time, the pancreas struggles to keep up with the increased demand for insulin. The result is that glucose levels become elevated. Chronic stress therefore increases the risk for diabetes.

What effect does stress have on weight gain and obesity?

Chronic elevated cortisol levels can lead to weight gain. One mechanism is to stimulate the storage of fatty acids in fatty tissue contained inside the abdominal cavity (visceral fat stores). Another way goes back to the blood-sugar insulin problem. Consistently high blood glucose levels, in the presence of insulin resistance, leads to cells that are starved of glucose. Since these cells are in need of energy, they send hunger signals to the brain via a biochemical signalling mechanism. This leads to increased eating and the intake of excess glucose that is eventually stored in the body as fat. Cortisol has also been linked to cravings for high-calorie foods.

What effect does stress have on the immune system?

Cortisol, being a steroid hormone, is similar to the drug cortisone, often used by doctors to suppress inflammation in virtually all tissue types. In the body, cortisol’s ability to suppress inflammation is mostly beneficial. However, this may also lead to the suppression of the immune system, causing an increased susceptibility to colds, flu and other infections, as well as an increased risk to develop certain forms of cancer. Cortisol is also associated with a tendency to develop food allergies and an increased risk of various gastrointestinal disorders, since a healthy intestine is dependent on a functional immune system. The risk of developing an autoimmune disease is also higher.

What effects does stress have on the gastrointestinal system?

The ‘autonomic nervous system’ is the part of the body’s ‘automatic’ control mechanism that regulates various involuntary bodily functions, such as breathing, digestion and circulation.  It consists of two divisions, namely the sympathetic and parasympathetic systems that, to a large degree, work in opposition to each other. When the sympathetic nervous system is ‘switched on’, the parasympathetic nervous system should ideally be ‘switched off’.

Whilst the sympathetic nervous system accelerates the heart rate, constricts blood vessels and raises blood pressure under stressful conditions, the parasympathetic nervous system does the opposite and helps to slow the heart rate, increase intestinal and glandular activity, and relax sphincter muscles.

The parasympathetic nervous system becomes more active during relaxed activities, such as eating. This is important because for the body to best use food energy, enzymes and hormones controlling digestion and the absorption of nutrients must be working at peak performance. Activation of the sympathetic nervous system by cortisol, however, results in the suppression of the parasympathetic nervous system. This compromises digestion and impairs the absorption of nutrients. As a result, indigestion and heartburn may develop and the mucosal lining of the gastro-intestinal tract may become inflamed. In response, mucosal inflammation of the stomach also leads to the increased production of cortisol, causing a vicious cycle. This is a reason why stomach ulcers are more common during stressful times. Those suffering from irritable bowel syndrome and inflammatory bowel disorders like ulcerative colitis also report an improvement in their symptoms when they master better stress management.

What effect does stress have on the cardiovascular system?

Through the activation of the sympathetic nervous system, cortisol constricts blood vessels and increases blood pressure in order to enhance the delivery of oxygenated blood during the fight-or-flight reaction. Over time, chronic arterial constriction also leads to high blood pressure and hardening of the arteries, which may cause heart attacks and stroke. This is one of the reasons why stressed-out personality types are at a greater risk for developing cardio-vascular disease.

What effect does stress have on fertility?

Elevated cortisol levels relating to prolonged stress can cause the disruption of menstrual cycles and ovulation, resulting in female infertility. Furthermore, the androgenic sex hormones are produced in the same glands as cortisol and epinephrine, so excess cortisol production may impair the optimal production of these hormones. Elevated cortisol levels are also known to cause erectile dysfunction.

What effects does stress have on fatigue?

Long-term stress and elevated cortisol levels are linked to insomnia, chronic fatigue syndrome, thyroid disorders, dementia and depression.

Which lifestyle changes can help to reduce stress?

Seeing that a chain is only as strong as its weakest link, the best way to manage stress is by using a combination of techniques. Start by eating a balanced, nutritious diet. Exercise regularly and avoid poisoning your brain and body with cigarettes, ‘recreational’ drugs and excessive alcohol intake.

Depending on your source of stress, there are various cognitive techniques that can be used to strategically plan, communicate and think better. These include techniques on how to manage conflict more effectively and how to put better boundaries in place between you and the people that cause you to become stressed.

In addition, we recommend the use of a regular supplement to assist you during times of excess work load or emotional fatigue. Roseroot (Rhodiola rosea) is a perennial plant that grows at high altitudes in the Arctic regions of Europe and Asia. Extracts of the roots have been used in Scandinavian and European countries to combat fatigue, reduce the effects of stress and to aid convalescence during illness. Several psychometric tests conducted on subjects under pressure demonstrated a substantial reduction in fatigue-related symptoms and an improvement of various cognitive indicators that are medically associated with increased psychological stress. These include a recorded reduction in cortisol levels. Roseroot has a low side effect profile and is generally considered a safe and effective supplement.

References

  • DSM IV Diagnostic criteria for acute stress disorder
  • World Health Organisation Guidelines on conditions specifically related to stress, 2013
  • American Institute for Preventative Medicine, General Stress Management, 4th edition 2012

Weight Loss

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Are you finding it more difficult than ever to lose weight? If so, you may have become insulin resistant. An easy way to find out is to check your waist circumference. Males with a waistline measurement of more than 94 cm and females more than 80cm have a high chance of having insulin resistance.

Do you want to lose weight and improve your health?

If so, we suggest that you follow a strategy that will:

  • Put your body into a fat burning mode by combatting insulin resistance
  • Help maintain your energy levels and prevent hunger and cravings
  • Be medically safe and help improve your overall health
  • Be practical and sustainable over the short and long term
  • Suppress the storage of fat and slow the formation of new fat cells

Despite what you may have been told, losing weight is difficult, everyone is different and there is no quick-fix solution. The reasons why people gain or fail to lose weight are numerous and scientifically rather complex. From our ever-increasing understanding of the biochemistry and genetics of obesity, one thing is clear; being overweight has a strong underlying biological foundation which can prove very difficult to overcome. What this means is that while you can make the physiological decision to lose weight and stick with it, your own body might not make it so easy.

Why do I gain weight so easily?

One gains weight because of the progressive accumulation of body fat and in some cases, additional tissue fluid. This process is based on two different mechanisms. The first involves growth of your existing fat cells, in other words, the ones that you were born with. Depending on your genetics, environment in the womb and other factors you may be at a disadvantage from day one, starting with more fat cells that are better and more efficient at storing fat.

The second, somewhat lessor known but equally important mechanism relates to how adults constantly make new fat cells, called adipocytes in medical terms, through the biological process of adipogenesis. This not only takes place in one’s existing fatty tissue, where new fat cells are squashed in-between those that already exist, but also begins to happen in other parts of one’s body which, under normal conditions, would not contain many fat cells. Once manufactured, these new fat cells start to accumulate more fat and progressively grow in size. Besides causing general weight-gain, these two mechanisms also lead to the progressive enlargement and distortion of fatty tissue, often referred to as ‘cellulite’ in cosmetic terms. The ability of fat cells to both grow and multiply therefore leads to an exponential increase in fatty tissue.

Added to the above, as your body puts on fat, it also accelerates this increase in fat. New research has shown that compared to lean adults, obese adults produce about twice as many new fat cells every year. Having built up a large supply of fat cells, and with each new cell making it easier to add to the pool, it is not surprising that so many overweight and obese people find it very hard to lose, and so easy to gain, weight.

More than a numbers game…

It is a generally accepted medical fact that excess body fat causes ill health. It is also known that the body has various self-regulating healing mechanisms that control or counteract disease. Ideally, one would expect the same to happen with excess body fat.

On the contrary, however, once fat cells progressively fill with fat, an odd and somewhat counterproductive phenomenon occurs. Instead of releasing its fat, which for obvious reasons would be beneficial to the ailing body, engorged fat cells start to safeguard their fatty content by progressively decreasing the release of fat. They also begin to tell other fat cells to do the same and to multiply in areas where fat would not usually be prevalent, such as the liver. Modern researchers searching for clues as to why this happens have discovered that the secret largely lies with the fact that engorged fat cells initiate a cellular communication process through the release of certain chemical messenger molecules, called ‘adipokines’. These messenger molecules start to communicate not only with cells in the immediate area, but also with other cells in distant parts of the body. Some adipokines trigger the formation of new fat cells whilst others disrupt the normal functioning of insulin, the hormone that controls metabolism.

The importance of insulin resistance

Although insulin is the dominant regulator of blood sugar control and therefore plays a crucial role in health, various studies have demonstrated that chronically elevated insulin levels also causes you to gain weight. This is due to the fact that insulin plays an intricate role in the body’s ability to store fat. Insulin as a hormone essentially puts your body into an energy storing mode, increasing the storage and creation of new fat, and making it harder to use this fat for energy. Insulin resistance is a condition during which the body fails to respond to the normal regulatory effects of insulin. Trying to overcome this, the body compensates by producing more insulin, causing blood insulin levels to rise.

Once insulin resistance sets in, your metabolism effectively slows down and it becomes increasingly more difficult to lose weight. This is because, with insulin resistance, fat cells stop releasing fat, leaving you virtually incapable of shedding those unwanted kilos.

Insulin resistance can be managed

In summary, you may be experiencing a real uphill struggle with your weight because:

  • You have more body fat, but that’s only part of the problem.
  • You most likely also have more fat cells.
  • In addition, you are adding to that pool by making new fat cells at twice the rate of a lean person.
  • To crown it all, your fat cells, because of the likely presence of insulin resistance, will biochemically be significantly less inclined to release their stored fat.

In order to lose weight, the modern therapeutic approach to improve your metabolism follows a strategy which optimises your body’s biochemical processes in such a manner that it simultaneously alleviates insulin resistance, suppresses the storage capabilities of fat by existing fat cells and prevents the continual formation of new fat cells. Therapies able to regulate both the size and number of fat cells over the long term have therefore become a new therapeutic goal to help treat overweight and obese individuals. In addition, this strategy should also help you to regulate your appetite.

But how can this be achieved?

Losing weight is not easy, but by rationally developing and actively implementing a weight loss plan based on all the different contributors to insulin resistance and fat accumulation, it can be achieved. Depending on the extent of weight you wish to lose, and underlying health conditions, this process may need to involve active participation from your healthcare provider, including various medications. In most cases, however, actively adjusting your lifestyle to focus on healthy habits together with complementary supplements can be enough to see a satisfactory change.

In order to get started on your journey towards a healthy lifestyle and slimmer body, follow these two simple steps:

  • Optimise your metabolism with AntaGolin. Read more.

Hormonal acne

What is hormonal acne?

Most of the acne we are familiar with is hormonal acne, also known as acne vulgaris. Most simply, it is acne that develops due to hormonal changes and imbalance, usually as a result of there being too much male hormone, or testosterone. Testosterone increases how much oil the skin secretes, which can lead to clogged pores. These can then be colonised by a bacteria known as Cutibacterium acnes, irritating the skin cells and leading to inflammation.

Hormonal acne is most common in teenage years when our bodies are undergoing many changes, but can arise at any time in your life.

Is there a difference between acne, hormonal acne, acne during puberty and acne vulgaris or are they all the same thing?

While the reasons for someone getting acne might differ, all acne is caused by excessive oiliness of the skin. While some people may normally have oilier skin, unexplained and regular bouts of acne all point to the same underlying causes – insulin resistance and hormonal imbalance. So while you have heard of different names, these acnes are actually the same. It should be noted, though, that hormonal change at certain times of one’s life, like puberty, is normal, even if uncomfortable, while at other times may point to a bigger problem.

How are acne, insulin and my hormones linked?

Insulin and hormone balance are tightly connected. When insulin becomes too high, it is able to suppress the action of female hormones, and enhance that of male hormones. At the same time, male hormones, like testosterone, are able to cause insulin resistance. What this leads to is a snowball effect where hormones become more imbalanced and insulin resistance increases.

Male hormones are also responsible for causing higher amounts of oil, or sebum, production in the skin, especially on the face. This leads to blocking of pores and the development of acne.

I’ve already undergone puberty or am an older adult, what does it mean if I still suffer from acne break-outs?

Experiencing acne past puberty is not so rare that you should be worried, especially if you only get a few spots every now and then. Acne can be caused by many things, and you should try and figure out what is associated with spots. If you’ve tried your best, however, and either can’t find any link, or your acne is persistent, it may be worth considering that underlying hormonal imbalance or insulin resistance may be the cause.

I only get acne a few times a year, should I be worried about PCOS, insulin resistance or hormonal imbalance?

If your acne occurs only intermittently, without any other symptoms, it is not likely caused by chronic insulin resistance or hormonal imbalance but more likely some lifestyle factor like stress or a poor diet during the holidays. However, even intermittent acne could be a sign of some underlying condition and should not be overlooked. This is especially the case if you experience any of the other symptoms of insulin resistance or hormone imbalance.

What are some symptoms of insulin resistance or hormonal imbalance that I should be especially aware of?

Insulin resistance and hormonal imbalances go hand-in-hand, and so symptoms of one condition can indicate the presence of the other. If you experience any of the below, especially in combination with acne, it may be prudent to consult with your doctor:

  • Difficulty losing weight or weight gain
  • A waist measurement over 80cm for a woman or more than 94cm for a man
  • Always hungry or thirsty
  • Excessive urination
  • Hair loss or growth
  • Emotional changes
  • Infrequent, irregular or prolonged menstrual cycles and/or infertility.

How can I address my acne and what are the treatments?

Acne can be caused by many things, but ultimately is a result of excessive oiliness of the skin leading to blocked pores, invasion by the bacteria C. acnes, and ultimately, inflammation. Treatment for acne should therefore be multi-layered, focussing on the underlying cause of oily skin, prevention of pore blockage and suppressing inflammation in the skin. In any of these cases, however, the over-bearing evidence is that acne can be significantly reduced by adopting positive lifestyle modifications:

  • Maintaining a healthy weight. Weight loss can reduce insulin and androgen levels and may restore ovulation. Even slight reductions (as little as 5%) can make a difference and improve fertility.
  • Avoidance of processed, high-carbohydrate foods. Diet should be centred upon plant-based, minimally processed foods comprising complex carbohydrates, healthy fats and proteins.
  • Staying active. Exercise helps lower blood sugar levels, reduce inflammation and improve hormonal regulation.
  • Avoiding toxic substances, such as tobacco and alcohol. Not only can these cause direct damage via oxidative stress, but also affect hormonal regulation and inflammation.
  • Practising a good skin care routine.
  • Avoiding dairy if it appears to make your acne worse.
  • Taking supplements like SkinVance+Zinc, aimed at improving insulin sensitivity, hormonal imbalance and reducing inflammation.

PCOS

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that leads to abnormal menstruation, problems with ovary function, cosmetic issues and infertility. PCOS is recognised as one of the most common disorders among reproductive aged women and is considered to be the leading cause of female infertility. By some estimates, one in every five women may meet diagnostic criteria.

Most often, symptoms first appear in adolescence, around the start of menstruation. However, some women do not develop symptoms until their early to mid-20s. Although PCOS presents early in life, it persists through and beyond the reproductive years. In PCOS, there is an imbalance in the hormones that control the menstrual cycle, often in combination with insulin resistance, which then prevent ovulation and decrease fertility.

Importantly, PCOS is not a clear-cut disorder, each person can experience varying degrees of the symptoms below- some may have just one or two while others have many.

What are the symptoms of PCOS?

The main symptoms of PCOS include, and can be varying combinations of:

  • Infrequent, irregular or lengthy menstrual cycles (30–50% have no periods at all)
  • Difficulty falling pregnant and low fertility (>90% are infertile)
  • Heavy bleeding (irregular periods can lead to heavier bleeding when menstruation does occur)
  • Weight gain or difficulty losing weight
  • Abnormal hair growth, often on the upper lip, chin, around the nipples and in a line beneath the navel (60-95% of persons)
  • Thinning hair or male-pattern baldness
  • Acne
  • Darkening of the skin, particularly along neck creases, the groin and underneath breasts
  • Skin tags (small growths or bumps of skin, especially in the armpits or neck area)
  • Ovarian cysts (multiple ‘cysts’, or small, fluid filled sacs in the ovary). Only your doctor can check for this

What disorders are associated with PCOS?

PCOS is primarily a metabolic and reproductive disorder. Specifically, PCOS is very similar to another chronic, metabolic disorder – Metabolic Syndrome (MetS), as well as a number of conditions associated with reproduction. Polycystic ovary syndrome, especially in the presence of obesity, increases the risk of both gynaecological conditions and a wide variety of many other diseases. The main ones are:

MetS associated disorders:

  • More than half of women with PCOS develop diabetes or prediabetes before 40
  • High blood pressure and cardiovascular disease
  • Obesity
  • Non-alcoholic fatty liver disease
  • Chronic, low-grade systemic inflammation

Reproductive disorders:

  • Difficulty conceiving and infertility
  • Gestational diabetes
  • Pregnancy-induced high blood pressure (preeclampsia)
  • Pregnancy abnormalities
  • Abnormal  bleeding in the uterus
  • Abnormal thickening of the lining of the uterus (endometrial hyperplasia)
  • Cancer of the uterus (a three times higher risk than those without PCOS)

Other disorders:

  • Sleep apnoea. Sleep apnoea is more common in women who are overweight and have PCOS, and is associated with numerous negative health outcomes, including increased risk for heart disease.
  • Depression and anxiety. Hormonal changes and symptoms like unwanted hair growth can negatively affect emotions.

What is the link between weight gain, insulin resistance and PCOS?

Approximately 70% of women with PCOS are overweight or obese. Excess weight, especially central obesity, is strongly associated with insulin resistance and systemic inflammation, both contributing factors to PCOS and other health conditions. In teenagers, obesity is the highest cause of anovulation (not ovulating) that continues into adulthood.

During PCOS, the ovaries produce abnormally high levels of androgen (male) hormones. These control the development of male characteristics and prevent the ovaries from releasing eggs, and can trigger extra hair growth (hirsutism) and acne. High androgen levels also contribute to insulin resistance through causing weight gain, resulting in the same metabolic outcomes as MetS. At the same time, increasing insulin leads to further androgen production, preventing menstruation and ovulation. It is therefore thought that high androgen levels together with insulin resistance creates a snowball-effect where increased insulin leads to higher androgen levels, which in turn increases insulin resistance and worsens PCOS.

What is an ovarian cyst?

An ovarian cyst is any collection of fluid, surrounded by a thin wall, within an ovary. Small ovarian cysts, called follicles, are normal and occur in both ovaries. A follicle that is larger than about 2cm is termed an ‘ovarian cyst’.

The diagnosis of polycystic ovaries is made when there are either 12 or more ovarian cysts, or when one or both ovaries are bigger than 10cm3.

Although 20% of all women have ovarian cysts, it does not mean you necessarily have polycystic ovary syndrome or vice versa.  These cysts are only one of the components of PCOS.

What are the treatments for PCOS?

Due to PCOS being a complex disorder resulting from many different underlying factors, there are no pharmaceutical drugs specifically designed for the condition. Rather, medications and treatments are prescribed to address specific symptoms, such as high blood sugar or unwanted hair growth.

Principles of the treatment of PCOS

  • Treatment is focussed on symptoms
  • Patients with mild symptoms might only require lifestyle modification and supplements
  • Treatment should be chronic and adapted to the changing circumstances, personal needs and expectations of the patient

Drug-based treatments

Drugs that are used for PCOS and its treatment include:

  • Hormonal therapies, including combination birth control pills, progestin, clomid (an anti-oestrogen medication) and gonadotropins. These therapies can work to reduce androgen production, or stimulate ovulation and menstruation.
  • Metformin, used to improve the insulin related aspects of the condition
  • Topical drugs, like creams, which act to prevent hair growth, acne, etc.

Lifestyle modifications

Lifestyle modification should be recommended to every woman with PCOS or any of its symptoms. Maintenance of healthy habits might reduce insulin resistance and its consequences, restore ovulation and improve fertility. These include:

  • Maintaining a healthy weight. Weight loss can reduce insulin and androgen levels and may restore ovulation. Even slight reductions (as little as 5%) can make a difference and improve fertility.
  • Avoidance of processed, high-carbohydrate foods. Diet should be centred upon plant-based, minimally processed foods comprising complex carbohydrates, healthy fats and proteins.
  • Staying active. Exercise helps lower blood sugar levels, reduce inflammation and improve hormonal regulation.
  • Avoiding toxic substances, such as tobacco and alcohol. Not only can these cause direct damage via oxidative stress, but also affect hormonal regulation and inflammation.

Supplements

Due to the complex nature of PCOS and MetS, many underlying deficiencies and imbalances develop and, in turn, contribute to these conditions getting worse. These are often in vitamins, minerals and compounds which the body naturally makes and uses, but due to metabolic imbalance, is making too little, getting rid of too much, or using incorrectly. For this reason, providing your body with these substances can prove highly beneficial to improving outcomes and symptoms of PCOS and MetS. Some of the most well-researched and effective supplements are:

  • Inositol, a naturally occurring nutrient which exist in the body in two forms: myo (MI) and D-chiro-inositol (DCI). Both act in fertility, reproduction and metabolic health. Problems in the balance between these two forms of inositol results in reduced insulin sensitivity and poor ovary function. Clinical studies have shown that inositol, especially at the ratio provided by OviVance, improves regulation of insulin and insulin sensitivity, ovulation and follicular maturation, egg quality and quantity and restores menstrual cycle regularity.
  • Vitamin D is well known to assist in MetS and PCOS through reduction in insulin resistance, dyslipidaemia and obesity.
  • Magnesium assists metabolic aspects of female health, especially in terms of MetS, PCOS and reducing the risk of gestational diabetes.
  • Selenium has well established roles in MetS and PCOS, insulin sensitization, and an inverse relationship with androgenic hormone levels
  • Zinc is important when addressing PCOS and MetS, especially through reducing inflammation and oxidative stress, improving insulin sensitivity, blood sugar regulation and dyslipidaemia.

OviVance, a unique blend of vitamins and minerals specially formulated by MNI to aid in improving fertility and PCOS, contains all of these vital substances in optimal amounts, helping you to enhance your reproductive and metabolic health as well as ovary function, whether you suffer from PCOS or just wish to improve your fertility. Try OviVance to take control of your reproductive health today.


REFERENCES
  1. Hursting SD, PhD, MPH. Obesity, Energy Balance and Cancer: Trends, Targets and Transgenics. 2003. Department of Carcinogenesis, University of Texas
  2. Linkov F, PhD. Cancer Epidemiology: The Need for Global Information Sharing in obesity and cancer? World Congress of Epidemiology, Aug 2011
  3. Pazaitou-Panayiotou, K., Polyzos, S. A. and Mantzoros, C. S. (2013), Obesity and thyroid cancer: epidemiologic associations and underlying mechanisms. Obesity Reviews. doi: 10.1111/obr.12070
  4. Yehuda-Shnaidman E, Schwarts B. Mechanisms linking obesity, inflammation and altered metabolism to colon carcinogenesis. Obes Rev. 2012 Dec: 13(12): 1083-95. Epub 2012 Sep 3.
  5. Birk S, Peeters A, Mackholder K, O’Brien P, Brown W. A systemic review of the impact of weight loss on cancer incidence and mortality. Obesity Review, Vol 13, Issue 10, pgs. 868-891, Oct 2012
  6. Gallagher EJ, MB BCH BAO MRCPI, LeRoith D, MD, PhD. Epidemiology and molecular mechanisms tying obesity, diabetes and the metabolic syndrome with cancer. Diabetic Care, Vol36, Sup 2, Aug 2013
  7. Messiah SE, Lipschultz SE, Natale RA, Miller TL. The imperative to prevent and treat childhood obesity: why the world cannot afford to wait. Clinical Obesity
  8. The Cancer Association of South Africa. http://www.CANSA.org.  Accessed 16 October 2013
  9. Krygsman, A. Can restriction of carbohydrate and/or omega fatty acids prevent breast cancer development? Dept. of Physiological Sciences, University of Stellenbosch.
  10. Albrecht, C MD. Cancer stakes its Territory- Causes and Link to Stress. Head of research, CANSA, Aug 2012
  11. Herbst MC, Prof. Fact sheet on Colorectal Cancer. Cancer Association of South Africa. June 2013
  12. Donna Kerrigan, M.S. Jeanne Kelly. Brian Hollen.  Understanding Cancer and Related Topics, Understanding Cancer Genomics. National Cancer Institute.
  13. Shmoop Editorial Team. “The Cell Cycle, Cellular Growth, and Cancer” Shmoop.com. Shmoop University, Inc., 11 Nov. 2008. Web. 17 Oct. 2013.
  14. Chow AY, PhD. (2010) Cell Cycle Control by Oncogenes and Tumour Suppressors: Driving the Transformation of Normal Cells into Cancerous Cells. Nature Education 3(9):7
  15. National Cancer Institute at the National Institutes of Health. Fact Sheet: Obesity and Cancer Risk. www.cancer.gov/cancertopics/factsheet/risk/obesity  Accessed 18 October 2013
  16. Nissen MJ, Shapiro A, Swenson KK. Changes in weight and body composition in women receiving chemotherapy for breast cancer. Clin Breast Cancer, 2011 Mar;11(1):52-60
  17. The Cancer Association of South Africa. Breast Cancer – Big & Small Let’s save them all. www.cansa.org.za Accessed 16 October 2013
  18. National Academy of Sciences. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary 2012

Sleep Patterns

The link between sleep, concentration, and mood.

Disrupted sleep may involve difficulty falling asleep, staying asleep or an alteration in the quality of sleep. This leaves the individual feeling unrefreshed, emotionally depleted, and vulnerable to the development of various mental and physical disorders.

What is the purpose of sleep?

Metabolism is a complex biological chain reaction that fluctuates all day. Anabolism is the set of metabolic pathways that construct new molecules from smaller units mostly derived from food. While anabolism takes care of the building-up and creational aspects of metabolism, catabolism is responsible for the breaking-down and ultimate degradation of cellular components.

At night, during the sleep-cycle, many of the body’s systems go into ‘anabolic state’, a renewal process that is essential for the restoration of the immune, skeletal, muscular, and nervous systems. These are also required to optimally maintain the function of neurons which ultimately regulate mood, memory, and cognitive function.

Of the most pronounced physiological changes that happens in the body during sleep occurs in the brain. This is because sleep allows the brain to use significantly less energy for ‘thinking’, thereby allowing it to replenish its energy supply in the form of the molecule ATP (adenosine triphosphate) required for nerve transmission, neurotransmitter production and nerve growth.

What are the consequences of poor sleep?

Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate sleep duration and/or quality of sleep to support your normal level of alertness and mental performance to get your hardworking brain through the next day. Sleep insufficiency can be either chronic or acute and may vary widely in severity.

Research has demonstrated that individuals with sleep deprivation problems are more likely to display decreased levels of concentration, battle to keep their mood upbeat and have an increased risk of developing a mood disorder or chronic pain syndrome.

Why should sleep deprivation not be ignored?

Over the last thirty years the concept that sleep serves a restorative function has gained strong scientific support from several research studies. More of these are emphasizing the key role of deep and proper sleep.

Two common symptoms of not getting enough sleep or poor sleep are fatigue and excessive daytime sleepiness. But having poor or insufficient sleep also increases one’s risk of developing a mood disorder such as depression and/or anxiety. This becomes a vicious cycle as sleep becomes more disturbed in a mood disorder, the mood disorder is more resistant to treatment unless the sleep disorder is concurrently treated, and lastly, any residual untreated sleep disorder increases the risk of relapse even after successful management of the mood disorder.

What does SleepVance contain?

SleepVance contains a unique blend of plant-derived (phytochemical) ingredients, vitamins and minerals known to promote healthy sleep patterns, increase sleep quality, and alleviate the daytime consequences of sleep deprivation. These are Valerian root (Valeriana officianalis), American skullcap (Scutellaria lateriflora) Passionflower (Passiflora incarnata), 5-hydroxytryptophan (5-HTP), Inositol, Glycine, Folate (as L-5-methyltetrahydrofolate), Magnesium, Vitamin B6, Vitamin D3, Vitamin C and Zinc.

What can SleepVance do for you?

  • SleepVance:
    • Aids with the promotion of healthy sleep patterns
    • Increases sleep quality
    • Alleviates the daytime consequences of sleep deprivation
    • It can be combined with any insomnia medication to improve sleep patterns

What are the side-effects and contra-indications of SleepVance?

  • SleepVance elicits natural sedative properties and should therefore not be taken before driving or operating heavy machinery.
  • Safety and efficacy in pregnancy and lactation has not been established and the administration of SleepVance during pregnancy and breastfeeding is therefore contraindicated.
  • Mild gastric irritation may occur if taken on an empty stomach, but generally, the natural ingredients in SleepVance have a low side effect profile.
  • Anyone with a known hypersensitivity or allergy to Valerian root, American skullcap, Passionflower, 5-HTP, Inositol or any other active or inactive ingredient in SleepVance should avoid taking SleepVance.

How should SleepVance be used?

ADULTS:

Take two tablets on a daily basis 1-2 hours before bedtime with supper or a later pre-bedtime snack/drink (preferably not on an empty stomach).

Tablets may be crushed or chewed to facilitate swallowing.

CHILDREN:

SleepVance is not recommended for children under the age of 18 years.

OLDER CHILDREN:

SleepVance contains the amino acid 5-HTP pharmaceutically registered in some countries for adult use only. SleepVance kids, a specialised teenage formulation, is better suited for children between 8 and 18 years.

YOUNGER CHILDREN:

SleepVance is not recommended for children under the age of eight.

Cognition and immunity

What is cognition?

Cognition is defined as ‘’the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses’’. While a lot of attention and research has focused on methods to increase attention, concentration and improve learning in general, not much has been done to ensure that the information learnt is adequately stored and easily retrievable when needed.

Cognitive processes involved in gaining knowledge and comprehension include thinking, knowing, remembering, judging, and problem-solving. These are higher-level functions of the brain and encompass language, imagination, perception, and planning.

  • AttentionAttention is a cognitive process that allows people to focus on a specific stimulus in the environment.
  • Language: Language and language development are cognitive processes that involve the ability to understand and express thoughts through spoken and written words. It allows us to communicate with others and plays an important role in thought.
  • LearningLearning requires cognitive processes involved in taking in new things, synthesizing information, and integrating it with prior knowledge.
  • Memory: Memory is an important cognitive process that allows people to encode, store, and retrieve information. It is a critical component in the learning process and allows people to retain knowledge about the world and their personal histories.
  • PerceptionPerception is a cognitive process that allows people to take in information through their senses (sensation) and then utilize this information to respond and interact with the world.
  • Thought: Thought is an essential part of every cognitive process. It allows people to engage in decision-making, problem-solving, and higher reasoning.

How can I help improve my family’s cognition?

Cognitive processes are influenced by a range of factors including genetics and experiences. While one cannot change their genetics, there are things one may do to protect and maximize their cognitive abilities:

  1. Stay healthy
    Lifestyle factors such as eating healthy and getting regular exercise can have an effect on your cognitive functioning.
  2. Think critically
    Question your assumptions and ask questions about your thoughts, beliefs, and conclusions.
  3. Stay curious and keep learning
    One great way to flex your cognitive abilities is to keep challenging yourself to learn more about the world.
  4. Skip multitasking
    While it might seem like doing several things at once would help you get done faster, research has shown it actually decreases both productivity and work quality.
  5. Use supplements
    A few natural compounds, vitamins and minerals have been shown to improve symptoms associated with ADHD, fatigue, concentration difficulties, impaired immunity, poor cognitive function, stress, and anxiety while causing few side-effects. Of these, some of the most effective are Rhodiola rosea (Roseroot), inositol, magnesium, vitamin C, zinc, and vitamin D3. The aforementioned ingredients are supported by science and are known to have positive effects on a range of factors associated with mental function.

    • Rhodiola rosea has been used for thousands of years in northern European countries to improve mood and combat stress. Recent research has uncovered its ability, in addition to these uses, to enhance mental function, memory and attention span, in part through increasing neurotransmitters such as dopamine in the brain. This is reflected in its wide use and recognition as an assistive therapy in Russia, Scandinavia, the UK, and Sweden.
    • Inositol is a naturally occurring B vitamin which is present in the body and a number of food sources, especially fruit, beans, and nuts. The molecule plays a role in a number of pathways in the brain, especially during the biosynthesis of norepinephrine. Low levels of inositol have been associated with some psychological conditions characterised by low mood, motivation and anxiety, and supplementation of inositol has been shown to alleviate these symptoms.
    • Magnesium is a biologically essential trace element which plays a vital role in the regulatory activity of over 300 enzymes involved in nerve conduction and the production of neurotransmitters. Magnesium helps to calm the nervous system down due to the mineral’s ability to block brain N-NMDA receptors (methyl D-aspartate), thereby inhibiting excitatory neurotransmission and mental overload. Inadequate magnesium levels have been linked to insomnia, anxiety, increased pain perception, and several neuropsychiatric problems. Conversely, studies on magnesium supplementation have shown significant improvement overall emotional well-being, sleep patterns, anxiety levels and mood.
    • Zinc is one of the most abundant trace minerals in the brain and supports several physiological, biochemical, and neurological functions. The bioavailability of zinc can influence central nervous system (CNS) function through a variety of mechanisms, and diets deficient in zinc have been known to result in behavioural disturbances and diminished brain function. (A meta-analysis of 17 studies with 1643 depressed and 804 control participants demonstrated that peripheral serum zinc concentrations were approximately -1.85 μmol/L lower in depressed participants). While the exact role of zinc in the pathophysiology of depression remains unclear, the inverse relationship between zinc levels and depression has been established in several studies that evaluated zinc bioavailability in depressed patients.
    • Vitamin D receptors are abundant throughout the central nervous system (CNS), especially in the hippocampus, a region of the brain that plays an essential role in the consolidation of information and the regulation of both short- and long-term memory. Research has also shown that vitamin D modulates several enzyme systems in the brain and the cerebrospinal fluid involved in neurotransmitter synthesis and nerve growth. Moreover, recent studies have shown Vitamin D to possess a neuroprotective effect as well as reduce neuro-inflammation, thereby improving cognitive function.
    • Vitamin C, one of the best-established neurological functions of vitamin C is in the regulation of neurotransmitter biosynthesis such as dopamine, adrenaline, and noradrenaline. Individuals who have vitamin C deficiency often report feeling both depressed and fatigued. Conversely, studies of hospitalised patients who often have lower than normal vitamin C levels have found a significant improvement in mood after receiving vitamin C supplementation. But vitamin C supplements might help improve mood even for people who aren’t known to have low vitamin C levels, as demonstrated by several studies. One study of high school students indicated that vitamin C supplementation lowered anxiety levels, while other studies have shown overall mood-elevating effects, including the reduction of anger.

NeuroVance Focus, a unique blend of the above scientifically endorsed plant-derived ingredients, has been developed by the Medical Nutritional Institute to improve neurological and immunological functioning safely and effectively. NeuroVance Focus is a unique blend of plant-derived phytochemical ingredients, vitamins and minerals that target multiple biological pathways recognised to reduce stress, improve concentration, cognition and focus, and promote calmness in both children and adults. As an assistive therapy, NeuroVance Focus can therefore help to improve cognition, concentration, brain function and focus as well as assist you and your child in reaching your full potential.

What is immunity?

Immunity by definition is the capability of multicellular organisms to resist harmful microorganisms. It involves both specific and nonspecific components, the nonspecific components act as barriers or eliminators of a wide range of pathogens irrespective of their antigenic make-up. Other components of the immune system adapt themselves to each new disease encountered and can generate pathogen-specific immunity. Immunity can be summed up as a complex biological system equipped with the capacity to recognize and tolerate whatever belongs to the self, and to recognize and reject what is foreign.

We have three types of immunity: innate, adaptive, and passive:

  • Innate immunity: Everyone is born with innate (or natural) immunity, a type of general protection. For example, the skin acts as a barrier to block germs from entering the body. And the immune system recognizes when certain invaders are foreign and have the potential to be dangerous/harmful.
  • Adaptive immunity: Adaptive (or active) immunity develops throughout our lives. We develop adaptive immunity when we’re exposed to diseases or when we’re immunized against them with vaccines.
  • Passive immunity: Passive immunity is “borrowed” from another source and it lasts for a short time. For example, antibodies in a mother’s breast milk give a baby temporary immunity to diseases the mother has been exposed to.

How can I help enhance my family’s immunity?

There are several dietary and lifestyle modifications that may help enhance your body’s natural defences and help you fight harmful pathogens and/or disease-causing organisms:

  1. Get enough sleep: Sleep and immunity are closely tied in fact; inadequate or poor-quality sleep is linked to a higher susceptibility to sickness. In a study of 164 healthy adults, those who slept fewer than 6 hours each night were more likely to catch a cold than those who slept 6 hours or more each night. Getting adequate rest may strengthen your natural immunity. Also, you may sleep more when sick to allow your immune system to better fight the illness. Adults should aim to get 7 or more hours of sleep each night, while teens need 8–10 hours and younger children and infants up to 14 hours. If you’re having trouble sleeping, try limiting screen time for an hour before bed, as the blue light emitted from your phone, TV, and computer may disrupt your circadian rhythm, or your body’s natural wake-sleep cycle. Other sleep hygiene tips include sleeping in a completely dark room or using a sleep mask, going to bed at the same time every night, and exercising regularly.
  2. Eat more whole plant foods: Whole plant foods like fruits, vegetables, nuts, seeds, and legumes are rich in nutrients and antioxidants that may give you an upper hand against harmful pathogens. The antioxidants in these foods help decrease inflammation by combatting unstable compounds called free radicals, which can cause inflammation when they build up in your body in high levels. Chronic inflammation is linked to numerous health conditions, including heart disease, Alzheimer’s, and certain cancers. Meanwhile, the fibre in plant foods feeds your gut microbiome, or the community of healthy bacteria in your gut. A robust gut microbiome can improve your immunity and help keep harmful pathogens from entering your body via your digestive tract. Furthermore, fruits and vegetables are rich in nutrients like vitamin C, which may reduce the duration of the common cold.
  3. Eat more healthy fats: Healthy fats, like those found in olive oil and salmon, may boost your body’s immune response to pathogens by decreasing inflammation. Although low-level inflammation is a normal response to stress or injury, chronic inflammation can suppress your immune system. Olive oil, which is highly anti-inflammatory, is linked to a decreased risk of chronic diseases like heart disease and type 2 diabetes. Plus, its anti-inflammatory properties may help your body fight off harmful disease-causing bacteria and viruses. Omega-3 fatty acids, such as those in salmon and chia seeds, fight inflammation as well.
  4. Limit/avoid added sugars: Emerging research suggests that added sugars and refined carbs may contribute disproportionately to overweight and obesity. Obesity may likewise increase your risk of getting sick. According to an observational study of around 1,000 people, people with obesity who were administered the flu vaccine were twice more likely to still get the flu than individuals without obesity who received the vaccine. Curbing your sugar intake can decrease inflammation and aid weight loss, thus reducing your risk of chronic health conditions like type 2 diabetes and heart disease. Given that obesity, type 2 diabetes, and heart disease can all weaken your immune system, limiting added sugars is an important part of an immune-boosting diet. You should strive to limit your sugar intake to less than 5% of your daily calories. This equals about 2 tablespoons (25 grams) of sugar for someone on a 2,000-calorie diet.
  5. Regular moderate exercise: Although prolonged intense exercise can suppress your immune system, moderate exercise can give it a boost. Studies indicate that even a single session of moderate exercise can boost the effectiveness of vaccines in people with compromised immune systems. What’s more, regular, moderate exercise may reduce inflammation and help your immune cells regenerate regularly. Examples of moderate exercise include brisk walking, steady bicycling, jogging, swimming, and light hiking. Most people should aim for at least 150 minutes of moderate exercise per week.
  6. Use supplements: Not all supplements provide you with the necessary vitamin and mineral levels required to have a significant positive effect on your immune response, however, some studies indicate that the following supplements may strengthen your body’s general immune response:
    • Vitamin C: Vitamin C is an essential micronutrient for humans, with pleiotropic functions related to its ability to donate electrons. It is a potent antioxidant and a cofactor for a family of biosynthetic and gene regulatory enzymes. Vitamin C contributes to immune defence by supporting various cellular functions of both the innate and adaptive immune system. It supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin, thereby potentially protecting against environmental oxidative stress. Vitamin C has also been shown to accumulate in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. It is also needed for apoptosis and clearance of the spent neutrophils from sites of infection by macrophages, thereby decreasing necrosis and potential tissue damage. According to a review of over 11,000 people taking 650-2 000 mg of vitamin C per day, it reduced the duration of colds by 8% in adults and 14% in children.
    • Vitamin D: Vitamin D deficiency may increase your chances of getting sick, so supplementing may counteract this effect. Vitamin D has the capability of acting in an autocrine manner in a local immunologic milieu. It can modulate the innate and adaptive immune responses. Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection. As immune cells in autoimmune diseases are responsive to the ameliorative effects of vitamin D, the beneficial effects of supplementing vitamin D deficient individuals with autoimmune disease may extend beyond the effects on bone and calcium homeostasis.
    • Zinc: In a review of 575 people with the common cold, supplementing with 12-75mg of zinc per day reduced the duration of the common cold by 33%. Zinc affects multiple aspects of the immune system. It is crucial a crucial component for normal development and function of cells mediating innate immunity, neutrophils, and natural killer cells. Macrophages also are affected by zinc deficiency. Phagocytosis, intracellular killing, and cytokine production all are affected by zinc deficiency. Zinc deficiency adversely affects the growth and function of T and B cells. The ability of zinc to function as an antioxidant and stabilize membranes suggests that it also plays a role in the prevention of free radical-induced injury during inflammatory processes.

NeuroVance Focus, a unique blend of the above scientifically endorsed plant-based ingredients, has been developed by The Medical Nutritional Institute to enhance immunity effectively and safely. The individual ingredients (vitamin C, vitamin D and zinc) target multiple biological pathways known to enhance the bodies’ resistance to infection in both children and adults.

Excess Central Weight

What is Excess Body Fat?

In humans and animals, adipose or fatty tissue is the body’s way of storing metabolic energy over extended periods. Depending on current physiological conditions, fat cells or adipocytes either store fat that is derived from the diet or liver metabolism, or release stored fat as fatty acids in times of additional energy requirement. These metabolic activities are regulated by several hormones, of which insulin, glucagon and cortisol play the dominant role.

The location of the fatty tissue determines its metabolic profile.  ‘Visceral fat’ is located within the abdominal cavity, beneath the wall of the abdominal muscle, whereas ‘subcutaneous fat’ is located beneath the skin (and includes fat that is located in the abdominal area beneath the skin but above the abdominal muscle wall). Visceral fat was recently identified as being a significant producer of various hormonal-like messenger chemicals, among which several have directly been linked to inflammation and the inflammatory response.

Two major mechanisms contribute towards weight gain. Not only do existing fat cells slowly increase the amount of fat that they store, but new fat cells are continuously being formed by the body. Besides causing weight-gain, this mechanism also leads to the progressive enlargement and eventual distortion of fatty tissue, commonly referred to as cellulite. Once this has happened, a counterproductive phenomenon occurs. Instead of releasing more stored fat, the body biochemically starts to reduce the ability of fat cells to release their contents of stored fat, making it more difficult to lose weight.

Modern research seeking clues as to why this happens has discovered that the secret largely lies with certain biochemical messenger molecules released by the actual fat cell themselves. Called adipokines, these chemicals not only play a dominant role in triggering the formation of new fat cells, but also start causing another condition, referred to as insulin resistance.

How do you measure body fat?

The standard way to classify an individual’s body weight is to calculate their body mass index (BMI). This is done by using a formula that divides their weight (kg) by their height squared (m2).

Underweight:          BMI > 18.5 kg/m2
Normal weight:       BMI 18.5 to 24.9 kg/m2
Overweight:            BMI 25.0 to 29.9 kg/m2
Obese class I:         BMI 30.0 to 34.9 kg/m2
Obese class II:        BMI 35.0 to 39.9 kg/m2
Obese class III:       BMI ≥ 40 kg/m2

Since many other factors that may falsely influence an individual’s weight according to the BMI classification (e.g. increased muscle mass, for example) lead to an erroneous overweight or obese classification, other measurements are often used in conjunction with BMI to assess an individual’s weight classification more accurately. These measures include waist circumference and body fat percentage calculations.

It is interesting to note that a normal weight BMI classification does not exclude excess body fat.  This may sound counter-intuitive, but recent medical research has shown that many individuals with BMIs below 25 actually have excess body fat that would only be detected by assessing body fat percentage, or by more sophisticated methods such as computer-aided tomography (CAT scans).  These individuals are now classified as ‘metabolically obese, normal weight’ (MONW).

Why is the distribution of excess body fat significant?

While overweight and obesity, in general, are associated with an increased risk of several diseases and premature death, research is showing that excess adipose tissue in the abdominal cavity (central or abdominal obesity) has a much greater influence on chronic inflammation. This is due to the fact that central adipose tissue has a significant hormonal effect on inflammatory cytokines, chemical substances released by cells, especially fat cells.

The resulting inflammation has been identified as a key role-player in a multitude of diseases including atherosclerosis, insulin resistance, diabetes, hypertension and many more.  In fact, it is now thought that chronic inflammation is the leading cause of all the components of the metabolic syndrome and could be the factor that forms the link between all its components.

The latest National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) defines central obesity as a waist circumference of ≥102cm in men and ≥88cm in women. In individuals with insulin resistance, the NCEP ATP III recognises that an increased risk of cardiovascular disease and diabetes exists at waist circumferences of ≥94cm in men and ≥80cm in women, which are the cut-off points used by the International Diabetes Federation (IDF).

How common is excess body fat?

The current global pandemic of obesity and excess weight is clearly illustrated by the 1.6 billion overweight adults worldwide, of which at least 400 million are obese. These numbers are expected to escalate in both developed and developing countries.

In the Western world, and specifically the USA, the prevalence of obesity has increased by 50% in each of the past two decades, with two-thirds of the US population being overweight, half of whom are obese. The majority of the increase is occurring in children, adolescents and men.

In 2008 the World Health Organisation estimated that 65% of South Africans were overweight (58.5% of men and 71.8% of women) and the figure is anticipated to rise, both locally and globally.

How are excess body weight and insulin resistance linked?

Adipose tissue (fat cells) has historically been accredited with only two main functions, namely that of storing energy for later use and preserving body temperature via improved insulation.

In the presence of excess body fat, however, adipose tissue also assumes a hormonal function and manufactures various chemical substances called ‘inflammatory cytokines’. For various reasons, some of these inflammatory cytokines disrupt insulin’s role on a cellular level and render it less effective. The medical term for this condition is ‘insulin resistance’. To get the same task done as before, the body compensates by producing, even more, insulin, causing levels to rise above the norm.

Because of insulin’s obesity-promoting effects, the subsequent elevation of insulin levels makes the individual more prone to gaining weight. In addition, higher insulin levels also make it more difficult to lose weight. Once this condition sets in, a vicious cycle begins, explaining why many overweight individuals find that their metabolism has effectively slowed down.

How are excess body fat and the metabolic syndrome linked?

The prevalence of the metabolic syndrome increases dramatically as BMI increases. Compared to normal and under-weight individuals, research has shown that overweight individuals are six times more likely to meet the criteria for the syndrome. This risk rises even further in obesity, where females are 17 times more likely and males are 32 times more likely to meet the criteria of the metabolic syndrome.

As described, excess body fat induces a generalised, chronic, low-grade inflammatory state. This is now considered to be the leading cause of all the components of the metabolic syndrome and the syndrome in its entirety.

How are excess body weight and stress linked?

Cortisol, a glucocorticoid (steroid hormone), is produced from cholesterol in the two adrenal glands located above each kidney. It is normally released in response to events and circumstances such as waking up in the morning, exercising and acute stress. Cortisol’s far-reaching, systemic effects play many roles in the body’s effort to carry out its processes and maintain homeostasis.

Cortisol also plays an important role in human nutrition. It regulates energy by selecting the right type and amount of substrate (carbohydrate, fat, or protein) the body needs to meet the physiological demands placed on it. When chronically elevated, cortisol can have negative effects on weight, immune function, and chronic disease risk.

One of the ways that elevated cortisol can lead to weight gain is via visceral fat storage. Cortisol can mobilise triglycerides from storage and relocate them to visceral fat cells (those under the muscle, deep in the abdomen). Cortisol also aids adipocytes’ development into mature fat cells. The biochemical process at the cellular level has to do with enzyme control (11-hydroxysteroid dehydrogenase), which converts cortisone to cortisol in adipose tissue. More of these enzymes in the visceral fat cells may mean greater amounts of cortisol produced at the tissue level, adding insult to injury (since the adrenals are already pumping out cortisol). Also, visceral fat cells have more cortisol receptors than subcutaneous fat.

A second way in which cortisol may be involved in weight gain goes back to the blood sugar-insulin problem. Consistently high blood glucose levels, along with insulin suppression, lead to cells that are starved of glucose. But those cells are crying out for energy and one way to regulate energy is to send hunger signals to the brain, which can lead to overeating. And, of course, unused glucose is eventually stored as body fat.

Another connection is cortisol’s effect on appetite and cravings for high-calorie foods. Studies have demonstrated a direct association between cortisol levels and calorie intake in populations of women. Cortisol may directly influence appetite and cravings by binding to hypothalamus receptors in the brain. Cortisol also indirectly influences appetite by modulating other hormones and stress responsive factors known to stimulate appetite.

What are the complications of excess body fat?

Excess body fat is directly linked to a wide variety of diseases, including insulin resistance, diabetes, chronic inflammation, cardiovascular disease, the metabolic syndrome and certain types of cancers. It is estimated that every 0.45kg gained between the ages of 30 and 42 years increases the risk of disease by 1%. This doubles to 2% between the ages of 50 and 60.

Excess body fat also contributes significantly to premature death, with studies suggesting that the risk increases by 20- 40% in non-smoking overweight individuals and by at least 2- 3 times among obese individuals.

How can lifestyle interventions affect excess body fat?

Generally speaking, the start of weight gain is an excess of calories: too many calories consumed and too few calories utilised. However, once excess body fat induces inflammation and insulin resistance, the weight gain process becomes more complicated due to the obesity-inducing effect of insulin.

Lifestyle interventions, including weight loss, increased physical activity and stress management have repeatedly been shown to improve chronic inflammation and insulin sensitivity, which in turn improve all the components of the metabolic syndrome.

While the thought of losing a tremendous amount of weight can be demoralising, it is important to realise that even small losses have a significant impact. The loss of every 0.45kg reduces an individual’s disease risk by 1%. This can be a very good motivator for overweight and obese individuals and the starting point to a healthier lifestyle.

References

  • Karelis AD, David H, et al. “Metabolic and Body Composition Factors in Subgroups of Obesity: What Do We Know?” The Journal of Clinical Endocrinology and Metabolism Volume 89 Issue 6 June 1, 2004.
  • Kassi E, Pervanidou P, Kaltsas G, et al. Metabolic syndrome: definitions and controversies. BMC Medicine 2011,9:48
  • The National Health and Nutrition Examination Survey (NHANES) 2003-2004

Type 2 diabetes

What is Diabetes?

Diabetes is a group of metabolic disorders that all manifest in one common symptom, namely high blood glucose levels. The underlying defect that leads to its development always relates to the hormone insulin, either as a result of a deficiency, or due to a fault in the way insulin conducts its biological function. In many cases, a combination of both these two defects is present in the same individual.

What are the different types of diabetes?

There are 3 different subtypes:
Type 1 diabetes
Type 1 diabetes is caused by the loss or destruction of the insulin-producing units in the pancreas, called ‘beta cells’. This leads to an acute or chronic shortage of insulin, causing blood insulin levels to drop. The majority of cases occur as a result of an auto-immune attack, where the body accidently destroys its own beta cells. Most people affected by type 1 diabetes are otherwise healthy and of normal weight. The onset of the condition is mostly sudden and symptoms develop rapidly. Type 1 diabetes accounts for about 5-10% of all diabetes cases.

Type 2 diabetes
Type 2 diabetes is caused by a sequence of events during which the body becomes less responsive to its own insulin. The underlying mechanism that leads to the development of type 2 diabetes is therefore referred to as ‘insulin resistance’. Unlike type 1, insulin levels actually rise as a result of insulin resistance, although a decrease in levels may also ensue at a later stage as the condition progresses and the beta cells fail to meet the increasing demand. The onset of the condition is usually slow and symptoms are often so subtle that they may go unnoticed for many months or even years. Type 2 diabetes accounts for about for 90-95% of all diabetes cases.

Gestational diabetes
Due to various physiological and metabolic changes that a pregnant woman naturally undergoes during the normal course of pregnancy, elevated blood glucose levels may occur. This is called ‘gestational diabetes’ and occurs in about 2-10% of all pregnancies. Resembling type 2 diabetes, gestational diabetes usually disappears after childbirth. However, having had gestational diabetes at some stage increases your risk of developing type 2 diabetes later in life.

What does the term’ pre-diabetes’ mean?

Pre-diabetes is the term used when fasting blood glucose levels are higher than normal, but not sufficiently elevated to qualify for the more formal diagnosis of diabetes. Pre-diabetes is also referred to as ‘impaired glucose tolerance’.

How common is diabetes?

The World Health Organisation (WHO) currently estimates that 10% of South Africans have elevated blood glucose levels. Globally, 285 million people are diagnosed as diabetic and this number is expected to increase to 439 million by 2030. Africa is set to experience a 100% increase in the number of diabetes cases in the next 15 years.

This increase is attributed to the growing obesity epidemic, urbanisation and increased life expectancy. However, many individuals with diabetes are unaware that they have the condition. A recent report released by the Centers for Disease Control and Prevention (CDC) indicated that 25% of Americans who have diabetes are currently undiagnosed. This figure is most likely to be much higher in South Arica.

What are the symptoms of type 2 diabetes?

Common symptoms include thirst, increased urination, fatigue, irritability, nausea, increased appetite, loss of weight, blurred vision and headaches. However, unlike type 1, type 2 diabetes may present in a slow and subtle manner with symptoms hardly even being obvious.

What are the complications associated with type 2 diabetes?

In uncontrolled diabetes, various pathological processes can develop that may lead to a number of serious life-threatening complications. This includes a significant risk of developing cardiovascular disease (CVD), which may result in heart attacks and stroke. If left unchecked, chronic elevated blood sugar levels cause tissue damage to a variety of organs, including the kidneys, eyes, peripheral nerves and all blood vessels. In most countries, uncontrolled diabetes is ranked amongst the leading causes of blindness, renal failure and lower-limb amputation.
The mechanisms that lead to these complications are complex and involve the direct toxic effects of high glucose levels on bodily tissue, together with the structural defects that occur in blood vessels such as arteries and capillaries.

Common complications of type 2 diabetes are:

  • Cardiovascular disease (angina, hypertension, heart attacks and heart failure).
  • Eye disorders (damage to the retina, cataracts, glaucoma and blindness).
  • Nerve disorders (neuropathy, numbness, tingling, burning, pain and poor bladder control).
  • Kidney failure.
  • Sexual dysfunction.
  • Dementia and cognitive dysfunction.
  • Poor wound healing and increased risk of infection.

What are the causes and risk factors associated with type 2 diabetes?

Non-modifiable risk factors for type 2 diabetes which cannot be changed are age, family history and race (genetic predisposition). Modifiable risk factors are associated with lifestyle and can all be changed to reduce the risk. These are excess body fat, smoking, a sedentary lifestyle and a poor diet.

How are diabetes and the metabolic syndrome linked?

Both pre-diabetes and type 2 diabetes are directly linked to metabolic syndrome.

How are diabetes and excess body fat linked?

Excess body fat plays a major role in the development of type 2 diabetics. This is because increased fatty deposits, especially those that accumulate around the abdominal area, cause various biochemical abnormalities that lead to insulin resistance. Read more about insulin resistance

What lifestyle measures can I take to prevent or manage diabetes?

Research has shown that by combining lifestyle changes with diabetic medication, the incidence of diabetic complications are reduced by 58%. This illustrates the significance and importance of lifestyle changes, not only in the prevention, but also in the management of diabetes. These include establishing healthy eating patterns, exercising regularly and losing weight where necessary.

Weight loss is mandatary in all overweight individuals with pre-diabetes or type 2 diabetes. The therapeutic advantages of weight loss not only help blood glucose levels, but also lower cholesterol and blood pressure levels too.

Which diet should I follow to help manage diabetes?

In the past, diabetics were advised to follow a “diabetic diet” rich in “complex carbohydrates” such as crackers and breads. The basic idea behind this concept was that complex carbohydrates in theory will take longer to digest in the intestines and therefore release glucose at a slower rate. “Simple carbohydrates”, in contrast, like sugars and fruit, would be absorbed too rapidly and were therefore limited or virtually forbidden.

However, according to the Glycaemic Index (GI), a more modern classification representing the total rise in a person’s blood glucose level following carbohydrate consumption, this advice was based more on assumption than fact. Most crackers and bread, for example, raise blood glucose levels much faster than pure white sugar. Fruit, especially grapes, were often excluded in the past, but vegetables such as potatoes were considered beneficial. Again, the GI has proved that this concept has little scientific foundation, since a baked potato, for example, has a much higher GI value than grapes, and therefore raises your blood glucose levels much faster.

The concept of the “diabetic diet” has therefore become obsolete, and the principles of diabetic dietary management are basically the same health-orientated guidelines that everyone should follow to control their body weight and reduce their risk for cardiovascular disease (CVD). Since diabetics have a higher risk of developing elevated blood cholesterol, hardening of the arteries and cardiovascular disease, it is therefore also important that diabetics adhere to a diet low in saturated fat, in spite of new controversial opinions regarding the intake of saturated fat.

Sources

  1. Prof. P Rheeder. Type 2 diabetes: an emerging epidemic. SA Fam Pract 2006;48(10): 20
  2. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2014.
  3. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetic Care Vol 37, Supplement 1, January 2014
  4. Alan J Garber et al. American Association of Clinical Endocrinologists’ Comprehensive Diabetes Management Algorithm 2013 Consensus Statement. Endocrine Practice Vol. 19 (Suppl 2) May/June 2013

Blood Glucose Levels

What is fasting blood glucose?

A fasting blood glucose test determines the concentration of glucose circulating in your blood stream after a fast, or in other words, after not eating or drinking anything other than water for 8 – 12 hours. The test itself is used to diagnose diabetes, and is easy to perform, convenient and less expensive than other tests. It is therefore the preferred test for initial screening for blood sugar disorders.

Why measure fasting blood glucose?

When fasting, such as in the period between dinner and breakfast, your body still needs glucose for energy, even though you have not eatenAs a result, it produces a number of hormones which activate the release of glucose from the muscles, liver and other tissues. This increases blood glucose levels. To prevent blood glucose from going too high, this is followed by release of insulin, slowing glucose release and promoting its uptake and use. In people with diabetes and prediabetes, however, this normal process becomes dysregulated. Either the body doesn’t produce enough insulin to rebalance blood sugar levels or it does not respond to the insulin produced. Blood sugar levels therefore continue to rise during fasting. When compared to non-diabetics, therefore, persons with diabetes or prediabetes will have a significantly higher blood glucose content when fasting. In a normal day, this translates to abnormally elevated blood glucose in the morning.

The assessment of fasting blood glucose offers an easy and quick view into how the body manages blood sugar levels. It may also be less variable than other tests, as these are taken sooner after meals and depend more heavily on what was eaten, activity levels and other factors. Despite this, the levels of fasting blood glucose do vary, and will be dependent on a number of factors, including the contents, size and time of the last meal, how the body responds to blood sugar variations and the person’s individual metabolic rate, amongst others. For formal diagnosis, therefore, abnormal blood sugar levels need to be observed on at least two separate occasions.

How is fasting blood glucose tested?

Fasting blood glucose can be tested by obtaining a small blood sample through a simple finger prick in a pharmacy or even at home. This basic assessment will give you an indication of your blood sugar levels. Accurate diagnosis, however, requires a proper blood test. After obtaining a blood sample, it will be sent away for analysis. Ideally, it is best to measure fasting blood glucose in the morning, as you will be in a natural fasting state after not eating since dinner the night before. Testing later in the day is not standard due to day time fasting not being normal, and the discomfort this may cause due to not eating during the day.

What do the numbers mean?

It is important to keep in mind that conclusions can only be made from the average result of at least two tests on different occasions. Blood sugar levels can fluctuate naturally, and a high reading once may not necessarily point to any underlying condition. Furthermore, blood sugar targets are depicted as ranges as there is no one blood sugar level that is ideal in every individual or at every time. As such, your own blood sugar level should be compared to these ranges and then, together with your doctor, interpreted in the context of your own body type, metabolic demands and lifestyle before a definite conclusion can be reached.

In areas outside the USA, including South Africa, blood glucose concentration is measured in millimole glucose per litre of blood (mmol/L). Typically, fasting blood sugar ranges are classified as follows:

  • 3.8 mmol/L or lessGenerally too low. Ingest sugar and seek medical attention if symptoms persist
  • From 3.9 to 5.5 mmol/L: Normal fasting glucose levels, ruling out diabetes
  • From 5.6 to 6.9 mmol/L: Impaired fasting glucose, indicating prediabetes and future risk of diabetes. Adopt a healthy lifestyle and seek medical advice.
  • 7.0 mmol/L and above: Diabetes. Seek medical advice and adopt a healthy lifestyle.

How can I reduce my fasting blood sugar?

Apart from medication recommended by your doctor, it is vital to follow a healthy lifestyle if you are to prevent short-term spikes in blood sugar, and, more importantly, stabilize or reverse long-term negative effects of high-blood sugar and diabetes. Adopting a healthy lifestyle and following the tips below can also prevent blood sugar metabolism problems from developing in the first place. Take action today, even if your blood sugar levels are normal.

healthier blood sugar level can be achieved by:

  • Eating a diet high in plant-based foods
  • Avoiding processed foods
  • Avoiding sweets and foods high in sugar. This may include limiting natural sources of sugar such as fruit.
  • Where carbohydrates are included, ensuring they are whole-grain and high in fibre
  • Focussing on high protein foods
  • Eating regular meals
  • Limiting alcohol
  • Getting regular exercise
  • Managing stress
  • Getting regular and adequate amounts of sleep

MNI places emphasis on assisting you with living a better lifestyle and therefore we developed lifestyle support tools:

  • For more information on how to follow a healthy diet, download our free C.A.P.E Meal Plan (your insulin-friendly meal plan) here.
  • You can also begin exercising by adopting one of our exercise plans. Download your free copy here.
  • For further assistance, try our range of products include unique blends of ingredients that work synergistically together to help improve your health outcome. Read more here.

Inflammation

What is Inflammation?

Inflammation is a complex biological process that the body activates in order to heal itself when injured, damaged by toxic chemicals or invaded by harmful micro-organisms.

Various cells, enzymes and hormonal-like substances are involved in the process. When triggered or ‘activated’, inflammation rapidly escalates into a cascade of consecutive biological events, a process that is largely controlled by small protein-based molecules called cytokines. After activation, inflammation has an immediate and local effect. Over time, this effect usually branches out and spreads to other parts of the body. Ideally, once inflammation has achieved its purpose of healing, it should automatically switch itself off. This is where things can potentially go wrong, since unregulated inflammation often becomes chronic and, instead of protecting the body, it starts damaging it.

What are the symptoms of inflammation?

When inflammation involves the skin, symptoms can be interpreted visually. With dermatitis or eczema, a rash appears. Early signs include redness, scaling, swelling or crusting. If allowed to progress, blistering, cracking and oozing may result. The body also perceives the presence of inflammation through the experience of pain.

A large number of inflammatory processes that take place within the body, however, do not present with any obvious symptoms. Although they remain active, they often go undetected until disease strikes its first blow. An example of this so-called “silent inflammation” is the process that takes place inside blood vessels such as arteries, veins and capillaries. Over time, this process damages the lining of blood vessels and leads to many life threatening cardio-vascular complications such as heart attacks, stroke and gangrene.

Of renewed medical interest is the inflammation that takes place within body fat. Whilst largely unrecognised in the past, the inflammatory consequences and detrimental biochemical agents that are produced by fat cells contained within fatty tissue are now directly associated with the development of insulin resistance and various other life threatening medical conditions associated with Metabolic Syndrome (MetS).

Preventing and lessening inflammation in your body is therefore not just a matter of day to day comfort, but long-term health.

“Inflammatory soup” – the ultimate biological brew

In response to injury or infection, a variety of chemicals are released by tissue cells, nerve fibres and immune cells at the site of the problem. These include various enzymes and pro-inflammatory messenger molecules called ‘cytokines’. Soon, additional cells and chemical substances produced in other parts of the body arrive at the scene of the action, summoned by the cytokines and shipped to the region via the bloodstream. A consequence of this brew of biological and cellular activity is inflammation and the milieu that it occurs within is commonly referred to as “inflammatory soup”.

Collateral damage – the consequence of chronic inflammation

When an injury occurs or the body is overrun by infection, blood vessels in the immediate region dilate to encourage the increase of blood flow to the problem region. This allows white blood cells to migrate towards the battlefield in large numbers. Arriving at the front-line, these immediately go to war. Of their most effective weapons are powerful inflammatory enzymes that, almost like pool acid, have the ability to dissolve protein.

When these enzymes dissolve enemy microbes and injured bodily tissue, it’s obviously beneficial. However, healthy tissue such as organs, blood vessels, nerve tissue and joints are also made out of protein and can therefore also be partially dissolved through the same process. The reality is that the effects of these enzymes cannot selectively be focussed, but more like carpet bombing, involve the entire region. In this case, inflammation causes cellular and structural damage to healthy tissue for no good reason.

Normally, once injured or affected tissue has been healed, the body shuts the process down by decreasing the production of its sabre-rattling warmongers, the ‘pro-inflammatory cytokines’ and increasing the production of its diplomatic peace-makers, the ‘anti-inflammatory cytokines’. The inflammatory process consequently burns out and the system returns to a non-inflamed state.

With chronic inflammation, however, the body, for various biochemical reasons, continues to produce pro-inflammatory cytokines. Like mercenaries without a war, these tend to get up to mischief, not only at the site of injury or infection, but by drifting off to other regions as well, thereby spreading inflammation and the consequences thereof throughout the body. Since this process has no benefit to the body, it is considered a pathological disease state.

Who is at risk of developing chronic inflammation?

A multitude of factors contribute to the development of chronic inflammation. These include environmental factors, diet, genetic make-up and stress levels. Excess body fat, especially when occurring in the abdominal area, is also linked to chronic inflammation. High-fat diets, low levels of physical activity and stress also play a role in increasing an individual’s risk of inflammation.

What is the link between inflammation and the metabolic syndrome?

Chronic low-grade inflammation is found in the majority of patients with the metabolic syndrome. It is also now known to play a dominant role in the development of the individual components of MetS, such as high blood pressure, abnormal cholesterol, glucose intolerance and obesity.

What is the link between inflammation and cancer?

Systemic inflammation and its biochemical impact play a pivotal role in the development of cancer. Once activated, chronic inflammation becomes a major breeding ground for cancerous mutations. Insulin resistance, especially in the presence of obesity, and its many interconnections with inflammation have directly been linked to a substantial increase in the incidence of cancer. In a recent study involving more than five million people, researchers investigated the effects of excess body fat on 22 different forms of cancer that represent 90% of all cancer cases diagnosed in the United Kingdom. It was found that Body Mass Index (BMI) was directly associated with 17 of the 22 cancers, especially cancers of the uterus, gallbladder, kidney and liver.

However, systemic inflammation is not exclusively linked to obesity and people of normal weight may also experience chronic inflammation as a result of other factors, including diet and physical inactivity. These individuals are therefore also at a higher risk of developing cancer.

What is the link between inflammation and pain?

A routine consequence of inflammation is the release of various biochemical substances that trigger the sensation of pain. Just as light reaching the receptors of the eyes sets off a biochemical reaction that result in sight, certain biochemical agents that are released during the process of inflammation activate pain receptors in the body. Once switched on, these pass pain messages via the nervous system to the brain. Chronic inflammation, therefore, plays a dominant role in a number of chronic pain syndromes, including joint and muscle pain, headaches and gastrointestinal pain.

What is the link between inflammation and stress?

Studies have shown that psychological contributors to systemic inflammation include stress, anxiety disorders and depression. Sleep disorders, including inadequate, interrupted or poor quality sleep, also contribute to increasing levels of chronic inflammation.

Chronic inflammation also causes an increase in the stress hormone cortisol which has the potential to disrupt the body’s immune system. This may result in an increased susceptibility to colds and other infections, as well as an increased risk of cancer.

How can lifestyle changes improve or manage chronic inflammation?

Medical science has increasingly been demonstrating that we are able to intervene in the process of chronic inflammation by making certain changes to our lifestyles. This helps to balance the body’s natural immune response and allows inflammation to achieve a more beneficial outcome instead of spiralling out of control and causing damage.

These lifestyle changes should address the environmental factors that contribute to chronic inflammation such as eating habits, physical activity, stress and excess body fat. A diet rich in whole foods with fibre and monounsaturated fats is inherently anti-inflammatory in biochemical terms. It will also contribute to weight loss when combined with restricted calories and exercise.

Mounting evidence also shows that regular exercise reduces inflammation, improves immune function, strengthens the cardiovascular system and corrects as well as prevents insulin resistance. Exercise also helps to reduce the negative consequences of stress on the system.

How can I improve, prevent or manage inflammation?

As already discussed, chronic inflammation is mostly a lifestyle disorder, meaning it is caused by unhealthy diets, lack of exercise and excessive intake of toxic substances like alcohol and tobacco. What is interesting about inflammation in particular, is that many food stuffs, herbs and spices, as well as exercise, efficiently lessen its impacts on long term health, through preventing inflammation inducing damage in the first place and actively calming the immune system. What this means is that whether you suffer from acute or chronic inflammation, or are only worried about the effects it might have should it arise, the best ways to address your concerns are the same. These are:

  • Follow a healthy and anti-inflammatory diet. This includes incorporation of fresh fruits and vegetables, high fibre, complex carbohydrates and cutting down on red meat where possible. MNI’s C.A.P.E. meal plan gives you a brilliant and comprehensive introduction to an eating style that will not only reduce inflammation, but improve your health over-all.
  • Stay active. Exercise is a potent anti-inflammatory, releasing numerous signals that help calm the immune system and keep it busy repairing muscle, rather than targeting innocent tissues. Exercise also goes a long way in reducing the chances of development of other chronic conditions associated with inflammation, such as diabetes and cancer. For beginners exercises allowing you to get started today, browse through MNI’s complementary exercise plans.
  • Avoid toxic substances, including excessive alcohol, tobacco and damaging food stuffs like processed carbohydrates and sugar. While your body has the ability to deal with very small amounts of these substances, it quickly becomes overwhelmed, leading to inflammation, damage to you organs and ultimately a wide array of chronic diseases.
  • Try FlamLeve today. FlamLeve is a natural anti-inflammatory agent that helps to combat inflammation, relieve pain and protect the internal organs against inflammatory damage. It can be used to alleviate pain and inflammation in several acute and chronic inflammatory conditions involving the muscles and organs. FlamLeve also helps to protect your body and organs from damage caused by inflammation and can therefore be used on a preventative basis as a daily supplement.

References

  1. Faloia Emanuela et al. Inflammation as a Link between Obesity and Metabolic Syndrome. Journal of Nutrition and Metabolism Vol 2012.
  2. Rosario Monteiro and Isabel Azevedo. Chronic Inflammation in Obesity and the Metabolic Syndrome. Mediators of Inflammation, Vol 2010.
  3. K Bhaskaran – Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults The Lancet, 14 August 2014.

Triglycerides

What are triglycerides?

Triglycerides are a type of lipid which make up most of the fat found in meats, dairy, cooking oils and your bodyBiologically, triglycerides are used for one of two purposes, either directly as energy or for storage of surplus energy as fat. When you think about excess weight, you are essentially talking about a build-up of triglycerides. Triglycerides can be obtained from your diet, or they can be manufactured in your liver from excess calories.

High triglycerides are associated with increased risk of atherosclerosis, heart disease and stroke. They are also inversely associated with HDL (or ‘good’) cholesterol levels. Knowing your triglyceride levels is therefore as important as measuring cholesterol.

Why measure triglycerides?

High triglyceride levels are associated with cardiovascular disease, including atherosclerosis, heart attack and stroke. They are also associated with lower HDL cholesterol and increasingly damaging LDL cholesterol. As with cholesterol, a high triglyceride level only has symptoms once it has caused diseaseTesting is therefore the only way to know if you should work at lowering yours. Excess triglyceride is also associated with the presence of a number of other disorders, including diabetes, obesity, liver and kidney disease, thyroid problems and Metabolic Syndrome. Early testing of triglyceride levels is therefore essential to effective management of your health.

How are triglyceride levels tested?

Preliminary screening for cholesterol abnormalities can be done in a point-of care clinic environment using a finger prick blood sample, which measures total cholesterol. Select clinics now also offer lipogram screenings which measures the different types of cholesterol and triglycerides. Although total cholesterol can give you an indication of your risk, a full lipogram is important to accurately test your cardiovascular disease risk and plan an effective intervention strategy. While it is usually required that you fast for 9 hours before doing the test, recent research has suggested that this is not actually necessary.

What do the numbers mean?

Higher levels of triglyceride have been associated with a greater risk of adverse health effects, especially those associated with the Metabolic Syndrome. Understanding your triglyceride levels, and interpreting them together with cholesterol measurements and your other risk factors is paramount to ensuring long-term health. This is a process that should be undertaken together with your doctor.

Triglycerides are measured in millimole per litre of blood (mmol/L). The numbers can be interpreted as follows:

  • Normal (therapeutic goal) – Less than 1.6 mmol/L. If your triglyceride levels are in this range, you are considered normal. You should aim to get your triglycerides as close to this, and even below, if possible.
  • Raised – 1.7 to 2.2 mmol/L. Lifestyle changes should be implemented.
  • High – 2.3 to 5.5 mmol/L. Adopt lifestyle changes urgently. Medication may be required.
  • Very high – 5.6 mmol/L or above. Lifestyle changes should be implemented immediately. Medication will be required.

How can I improve my triglyceride levels?

The primary method for correcting abnormally high triglyceride levels is lifestyle intervention. Much of the advice overlaps with that prescribed for other conditions associated with Metabolic Syndrome, especially high cholesterol and cardiovascular health. Through following the tips below, therefore, you will not only be actively lowering your triglycerides and improving your heart health, but bettering your health overall.

As with other aspects of general health, it is never too soon to begin practising a healthy lifestyle. Even if your triglycerides are normal, you can lower them further, reduce your risk factors for disease and increase your quality of lifeboth now and in the future.

If you are required to take medication, making sure to still implement lifestyle changes will further improve your health as well as keep your medication dose low.

Some ways to specifically reduce triglycerides are:

  • Ensuring you generally eat only as much food as you use for energy. Any extra will be immediately converted to triglyceride and stored as fat.
  • Losing weight. Fat is itself an accumulation of triglycerides, and can signal to your body to produce more.
  • Quit smoking. Tobacco smoke affects lipid levels and makes them more likely to cause damage to your arteries.
  • Restrict carbohydrates, especially heavily processed, high energy sources. These are easily converted to fat and contribute to an array of diseases and disorders.
  • Restrict saturated fat, the major dietary source of damaging triglycerides. This will involve a reduction in the consumption of animal products.
  • Increase your consumption of fish, nuts and seeds that contain omega-3 fatty acids and other healthier, monounsaturated oils.
  • Limit alcohol. Alcohol is high in calories and has a particularly serious effect on triglyceride levels.
  • Exercise regularly. Regular exercise will use up extra energy and fat as well as improve lipid profiles.
  • Take a supplement aimed at improving heart health and optimising cholesterol levels.

MNI places emphasis on assisting you with living a better lifestyle and therefore we developed lifestyle support tools:

  • For more information on how to follow a healthy diet, download our free C.A.P.E Meal Plan (your insulin-friendly meal plan) here.
  • You can also begin exercising by adopting one of our exercise plans. Download your free copy here.
  • For further assistance, try our range of products that include unique blends of ingredients that work synergistically to help improve your health outcome. Read more here.

Blood Pressure

What is blood pressure?

Blood pressure is the force which moves blood around your body. Every time your heart beats, it is actually contracting like a pump and pushing blood out of its valves and into your arteries. In order for your blood to flow, your arteries squeeze back, ensuring it moves forward. The strength of this pressure is your blood pressure. How hard your heart pumps, how elastic your arteries are and a number of other factors determine how high or low your blood pressure is.

How is abnormal blood pressure diagnosed?

High blood pressure, or hypertension, is often called the silent killer, as there arusually no symptoms associated with it. Generallythe first sign will be a heart attack, stroke or kidney failure. The only way to know what your blood pressure is, is to have it measured. Low blood pressure, or hypotension, is associated with light headedness or dizziness. If you are in a high risk group or have a family history of high or abnormal blood pressure, it is essential you have your blood pressure tested.

How is blood pressure measured?

Blood pressure is measured using an instrument called a sphygmomanometer. The doctor or nurse will place a rubber armband around your upper arm and inflate it. From here the doctor will measure your blood pressure. The procedure is quick, easy and painless.

The measurement is taken using two numbers, called systolic and diastolic blood pressure. Systolic pressure is the maximum amount of pressure exerted when your heart pumps, and diastolic pressure is the amount of pressure your arteries exert to force blood forwardblood pressure of 120 over 80, written as 120/80 mmHg, for example, means you have a systolic blood pressure of 120, and a diastolic blood pressure of 80. The units of measurement are mmHg, or millimetres of mercury, a reference to a time when medical pressure gauges used mercury.

Why is abnormal blood pressure problematic?

Blood pressure is tightly controlled in order to keep you healthy. If blood pressure is too low, blood doesn’t move fast enough around your body, and your tissues do not receive enough oxygen and nutrients. If blood pressure is too high, unnecessary stress is placed on your cardiovascular system. High blood pressure makes your heart work harder to pump blood. It also puts extra strain on your arteries and organs, especially your brain and kidneys. High blood pressure may therefore lead to heart attacks and strokes, the risk of which double with every increase of 20 mmHg systolic or 10mmHg diastolic blood pressure, as well as kidney failure and other disorders.

When is a blood pressure measurement abnormal?

It is important to note that high or low blood pressure can only be diagnosed from a number of readings over a period of time. One abnormal reading does not mean you have high blood pressure, but could be a result of some acute stress, illness or a number of other factors.

Blood pressure ranges are categorized as follows (sourced from The Heart and Stroke Foundation of South Africa):

Low blood pressure

In general, low blood pressure is actually desirable. It only becomes problematic when the brain and other organs are not getting enough oxygen. The point at which this happens varies from person to person, and so what constitutes low blood pressure is dependent on your own body.

Symptoms indicating your blood pressure has fallen too low include dizziness, light-headedness and fainting. If you regularly experience these symptoms, see your doctor.

In some cases, blood pressure can fall dangerously low and be life-threatening. If the below symptoms are experienced, seek medical attention:

  • Confusion, especially in older people
  • Cold, clammy and pale skin
  • Rapid, shallow breathing
  • Fast, weak pulse

Optimal blood pressure (less than 130 / 85 mmHg):

If your blood pressure falls within this range it is normal. Adopt heart-healthy habits or keep them up to ensure your blood pressure does not start to rise.

Elevated blood pressure (130-139 / 86-89 mmHg):

Elevated blood pressure is a sign that a problem could be developing. Although no medications are required at this stage, you should begin to practice a heart-healthy lifestyle. If you’re older than 65, your doctor might recommend treatment to further ensure your blood pressure does not rise.

Mild hypertension (140-159 / 90-99 mmHg):

If you are experiencing mild hypertension, lifestyle changes are essential and doctors may consider including blood pressure medication based on your risk of cardiovascular disease.

Moderate hypertension (160-179 / 100-109 mmHg):

If you have moderate hypertension, doctors will prescribe a combination of blood pressure medications and lifestyle changes. Both are extremely important to ensuring long-term positive health outcomes are reached.

Hypertensive emergency (from 180 / 110 mmHg):

If your blood pressure is higher than 180/110 mmHg and/or you are experiencing the following symptoms, you should seek emergency treatment:

  • Chest pain
  • Shortness of breath
  • Visual changes
  • Symptoms of stroke, such as paralysis or a loss of muscle control in the face or an extremity
  • Blood in your urine
  • Dizziness
  • Headache

How can I lower my blood pressure and what can I do to prevent it from rising?

Even if your blood pressure is normal, it is still important to ensure you practice heart-healthy habits. As you age, arteries naturally increase in stiffness, plaque builds up inside them and blood pressure increases. This is coupled with the general decline in cardiovascular health with age. Certain other conditions such as diabetes and kidney problems may also contribute.

The following habits will help to lower or prevent a rise in blood pressure, as well as keep you healthy in general:

Reduce salt intake

Sodium (or salt) is part of the natural signalling system keeping blood pressure in check. A diet high in salt can disrupt this balance, leading to an increase in blood pressure. Generally, persons at risk of blood pressure issues shouldn’t consume more than 2300 mg per day. People who already have high blood pressure may need to reduce this even further.

The easiest way to cut down your salt intake is to refrain from adding extra to your food. Instead, make use of herbs and spices to flavour your food. These also have their own positive health benefits. It is also wise to avoid processed foods which are generally high in sodium, as well as foods such as french fries, biltong and others which use salt as flavouring or a preservative. If in doubt, check the nutritional information on the package.

Download our C.A.P.E meal plan for meals and recipes naturally low in sodium.

Reducing caffeine intake

Caffeine and other stimulants can increase blood pressure, partly through increasing heart rate. Reduce intake of caffeine and other stimulants in order to help keep your blood pressure low.

Exercise

Exercising has many benefits, including reducing blood pressure and resting heart rate. It will also improve the health of your heart, arteries and organs, significantly reducing your chances of heart attack, stroke and other cardiovascular disorders. In order to maximise the effectiveness of exercising, it is better to exercise for shorter periods more frequently (at least 30 minutes a day) as opposed to longer periods only once or twice a week. If this is difficult for you, keep in mind that any exercise is better than none – park your car further away from the shop entrance or office, climb the stairs or do some gardening.

Download one of our free exercise plans for simple daily exercise routines.

Note, that it is important to obtain permission from your doctor to exercise if diagnosed with serious hypertension.

Maintaining a healthy weight

Excess weight is one of the chief contributors to cardiovascular disease and high blood pressure. Losing even a few kilograms can make a huge difference to your blood pressure. Adopt a healthy diet and exercise to begin losing weight today.

Try AntaGolin, the C.A.P.E meal plan and our exercise programs to start losing weight today.

Managing stress

Stress naturally increases your heart rate, blood pressure and other contributors to cardiovascular disease. When you are threatened, these serve to improve energy and alertness so you can better deal with the danger. In the modern world, however, this stress is too often chronic, leading to constantly elevated blood pressure and other health issues.

Stress doesn’t have to rule your life and take its toll on your health. Try NeuroVance or NeuroVance Focus today.

Find out how serious your stress levels are with our FREE stress test.

Reducing alcohol intake and quitting smoking

Both alcohol and smoking contribute significantly to cardiovascular disease. Avoiding smoking and excessive alcohol consumption could very well be the difference between having a healthy heart and early cardiovascular disease. Quit smoking as soon as possible and limit your alcohol consumption to only a few drinks per week.

Diet

Diet can both cause and prevent disease, it’s all about what, and how much, you eat. A healthy diet is essential to good health. This is not only in terms of keeping your blood pressure down, but also in avoiding diverse lifestyle diseases, including cardiovascular disorders, diabetes and cancer. Eat a diet high in fruits and vegetables and avoid processed foods. Where possible, foods should be as close to their natural form as possible.

Download our C.A.P.E meal plan for more tips and recipes for a heart-healthy diet.

Pain and inflammation

The link between pain and inflammation

What is Inflammation?

Inflammation is part of a complex biological response serving to help combat infection, restore injured tissues, and neutralise toxins. Besides helping to eliminate the initial cause of cell injury (such as a microbe or toxin), inflammation also helps clear out dead cells and damaged tissues in preparation for tissue repair.

Why can inflammation be harmful to the body?

In order to clear out dead cells and tissues, several different protein-degrading enzymes are produced during the inflammatory process. These enzymes are highly corrosive and dissolve any protein-based tissue, often at an astonishing rate. Protein-degrading enzymes are also the main defensive weapons used by white blood cells to destroy foreign microbial organisms. Since the caustic activity of these enzymes cannot be selectively contained within a specific region, collateral damage to structurally sound tissues commonly occurs. Over time, the rate of tissue damage overtakes the rate of repair, resulting in a nett loss of bodily tissue.

Why is inflammation also the leading cause of chronic pain?

Pain is perceived through specialised nerve cells (neurons) called nociceptors. Situated throughout the entire body, they respond to potentially damaging stimuli by sending pain signals to the brain via the spinal cord. This process, called nociception, is biochemically triggered by several different kinds of signalling molecules produced during inflammation. Chronic inflammation is therefore also the leading cause of both acute and chronic pain.

Painful conditions caused by chronic inflammation: