2. Sam Young, MD Family Physician Community Health Advocate Former US Army Medical Corps Colonel Born and raised in Savannah, Georgia 30 years of combined clinical experience in Traditional & Complementary Medicine
3. The Impact of Obesity on the Local Community www.Choose-Health.org
5. My personal story as well,… Me before… 212 lbs 05/29/2001 200 lbs June 2009 212 162 lbs Sept 2009 197 lbs
6. Me 12 weeks later, and since… 212 lbs 05/29/2001 200 lbs June 2009 212 162 lbs Sept 2009 197 lbs
7. My Four Objectives Today(using recent medical evidence) 1. Demonstrate Obesity as the Major Community Health Crisis 2. Identify the Primary Cause…. Insulin Resistance Show how simple lifestyle changes can actually Reverse Insulin Resistance and Obesity through - Low Glycemic Food Choices - Moderate Consistent Exercise - Community Awareness 4. Relate these to The Metropolitan Planning Commission’s Strategic Plans, which will play an extremely critical role in our community’s success, …or failure
8. My two KEY Individuals in Obesity, Insulin Resistance Low Glycemic NutritionResearch Dr. David Jenkins & Dr. David Ludwig
9. David J.A. Jenkins, M.D., Ph.D., D.Sc. Developed the Concept of The Glycemic Index
10. David Ludwig, MD, PhD Pediatric Endocrinologist International expert on Childhood Obesity Principle Author of over 40 research studies on Adult and Childhood Obesity, Insulin Resistance, Chronic Disease, and Nutrition Director, Optimal Weight for Life (OWL) Program at Children's Hospital Boston
11. Obesity, the #1 Health Threat in the USA 33% of US adults are obese, & another33% are overweight By the year 2020 45% will be obese, & another >33% will be overweight
12. Recent CDC reports “Diabetes Belt” Tightens Around the South The same CDC reportalso found higher levels of Obesity in the South as well March, 2011 American Journal of Preventive Medicine
13. Obesity dramatically increases risk of Diabetes, Heart Disease, and many other Chronic Diseases Obesity significantly decreases the length and quality of an individual’s life andInsulin Resistanceleads to Obesity
14. 33%of US children are either overweight or obese This dramatically increases their lifelong risk of Diabetes, Heart Disease, and other Chronic Diseases Despite living in the most developed nation on earth and for the first time in our history, the life expectancy of children in the USA today is less than it is for their parents Insulin Resistancealso leads to Childhood Obesity
15. The#1 Health Threatfacing Savannah & Chatham County is Obesity Childhood and Adult Obesity are most commonly the result of Insulin Resistance
16. Insulin, a hormone made in the pancreas Lowers Blood Sugar The “Insulin” Funnel Think of insulin as a funnel to help move sugar from the blood into the cell
17. Some foods elevate the blood sugar slowly and gently These are called Low Glycemic Foods or “Real Foods” Nuts, berries, vegetables, fruits, beans, whole grains
18. Th and little insulin then required to control the blood sugar This is Desired and Good Blood Glucose meal meal Time Low Glycemicfoods gently increase blood sugar levels
19. Some foods elevated blood sugar too fast and too high High Glycemic Foods or Fake Foods* Dr. Ludwig *Highly processed foods made in factories, such as sweetened cereals, sugary drinks, chips, cookies, candy, white bread and fast food
20. High Blood Sugar more insulin is required to lower the blood sugar, which is bad because overtime, it leads to insulin resistance Blood Glucose meal meal Time High Glycemic Foods Spike Blood Sugars Stress Hormones released due to too much insulin release Over Hungry
22. To Control Ongoing Blood Sugar Spikes Insulin Production Rises And Insulin Resistance Begins
23. Insulin Resistance and Ongoing High Insulin Demand Eventually Exhaust the Pancreas Insulin Production Falls Fasting Sugar Elevates Type II Diabetes Results
24. Carbohydrates All carbohydrates are composed of sugars Short chains of sugar, simple carbohydrates(glucose, sucrose, lactose and fructose) were traditionally thought to be digested very quickly Long chains of sugars called starches or complex carbohydrates were thought to be digested more slowly than simple sugars But is this actually True?
25. David J.A. Jenkins, M.D., Ph.D., D.Sc. Dr. Jenkins began testing the actual effectsof carbohydrate containing foods on blood sugar and insulin levels in the 1970’s, and developed the concept of the Glycemic Index Dr. Jenkins’ findings were reported in the American Journal of Clinical Nutrition in 1981 1984, 1985, and 1987 As well as the NEJM 1989, Diabetes 1990, and British Medical Journal in 1998
26. The Glycemic Index Dr. Jenkins measured the area under the blood sugar curve after Glucose was given. He used Glucose as the standard and assigned it a Glycemic Index value of 100 units. He then compared other carbohydrate foods to glucose’s Glycemic Index of 100 units. Blood sugar curve for glucose Area under blood sugar curve Test Food Given
27. Examples ofGlycemic Index (GI) Low Glycemic Foods High Glycemic Foods GI Apple 36 Low fat yogurt 31 Lentil beans 29 Chickpeas 28 Sweet Cherries 22 Black Beans 20 Peanut 14 Almonds 0 Avocado 0 GI Baked Potato (no skin) 98 Instant White Rice 91 Corn Flakes 84 White Bagel 72 Jelly Beans 78 Pretzels 83 Table Sugar (sucrose) 61 Glucose 100
28. Spiking Blood Sugar Promotes Insulin Overproduction Highly processedbreads, rices, cereals, and baked potatoes are high glycemic foods and spike blood sugarfasterthan table sugar 85 to 90% of the carbohydrates in the USA are highly processed and high-glycemic, and promote overproduction of Insulin, Insulin Resistance, and Obesity
29. Insulin Resistance Increases Risk for Metabolic Syndrome Pre - Diabetes Heart Disease Obesity Stroke Diabetes Sleep Apnea Premature death Related Clinical Findings Central Obesity High Blood Pressure Cholesterol Problems High Blood Sugar Trouble Losing Weight Food Cravings
30. High Glycemic foods are everywhere The major reason for skyrocketing rates of obesity is that we are surrounded by high glycemic foods The fast food and beverage industries target children, and adults If we were taken back to the 1960’s most obesity would disappear Never before have so many kids been so heavy so early in life Dr. David Ludwig
31. The Fake Food versus“Stone Age Food”Game "Fake food is a concept that kids can get in a few minutes, and once they get it, it can guide them to make some dramatic changesin their eating habits“ Dr. David Ludwig Write down foods normally eaten now Circle foods not present in “Stone Age” Call these “Fake Foods” (usually 70%) Eat more “Stone Age Foods”
32. Simple Low-Glycemic Food Pyramid limit refined grains, breads, pasta and potatoes Lots of non-starchy vegetables
33. Selecting Low Glycemic Foods Typically whole foods, eaten in their natural state. Examples include most fruits, non-starchy vegetables, beans, nuts, berries and whole grains. Requires a commitment to simple lifestyle changes which are clearly supported by medical evidence
34. American Association of Endocrinologists In response to obesity, metabolic syndrome and diabetes epidemics in the United States, the Fall 2008 AACE/ACE Consensus Report Recommended the First Step should be ….. Intensive Lifestyle Changes
35. Just How Effective is Lifestyle Change?VERY EFFECTIVE!!! In this Clinical Study, Four Simple Lifestyle Changes were used for 12 weeks August 2009 Holly R. Wyatt, MD Center for Human Nutrition University of Colorado
36. Obesity and Weight Management Journal August 2009, pages 167-173, peer reviewed Overweight Patients age 20-60 years Pre-Diabetes, (Metabolic Syndrome) Not on cholesterol or diabetes medications 12 week program Low Glycemic Nutrition 2. A Moderate Exercise Program 3. High Quality Multiple Vitamins 4. Internet Coaching Program The study results are shown next…
46. Savannah is a community committed to supporting healthy lifestyles The Healthy Savannah Initiative is dedicated to making Savannah a healthier place to live by… 1. Promoting Health Awareness through Education 2. Increasing Access to Quality Nutrition 3. Encouraging Safe Consistent Physical Activity And each of these three help reduce insulin resistance and obesity
47. Parental Lifestyle Modeling Critical Families should rid their homes of most “fake foods” and increase “real foods” Everybody in the family wins if the food environment at home is better Adults should also be models for safe consistent moderate physical activity also known to prevent insulin resistance
48. “Community” Lifestyle Modeling also Critical to Combat Insulin Resistance and Obesity Communities should significantly increase access to “real foods” and help “Make the Healthy Choice the Easy Choice” Everybodywins if the food environment in the community is better GROUNDBREAKING FOR SAVANNAH’s SHUMAN MIDDLE SCHOOL GARDEN PROJECT 23 March 2011
49. Physical Activity reduces Insulin Resistance and Obesity Civic leaders and planners should also encourage safe consistent moderate physical activity to promote community wellness
50. Overview of Key points Insulin Resistance is a Major cause of Childhood and Adult Obesity Insulin Resistance and Obesity can be PREVENTED and REVERSED through appropriate Lifestyle Changes Civic leaders & planners are in a very unique positionto positively influence the health of entire communities for decades to come