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August 2000 Issue
You're Slim ... But Are You Healthy?
by Michael Fick
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Don't presume you don't have Syndrome X, because it's easy to make an educated guess from numbers you should already know. If your HDL is under 40 and your triglycerides are over 200, you need to check one more number - your blood glucose level -- the next time you have your cholesterol checked this year. If your non-fasting blood glucose is below 90, relax. If it's over 90, a fasting blood glucose test is advisable. If that's over 126, you have a much more immediate problem -- you have diabetes. If your fasting glucose runs between 110 and 126, you are insulin resistant and it is dangerous. You should start educating yourself and your doctor now (or finding one who reads more, if necessary).

The tendency for insulin resistance is probably half genetic, but it's primarily excess weight and sedentary lifestyles that drive it over the edge. Exercise, moderate weight loss, and a moderate decrease in your carbo intake may save your life if you're insulin resistant.

Does this mean Dr. Atkins' high-grease/high-cow diet is healthy, that the high-protein promoters simply disagree with Dr. Reaven, and that time will tell who's right? No, no, and no, because they misquote his research to support their claims and he considers their misinterpretations dangerous. High protein/high fat/low carb diets still overwork our kidneys and liver, and their saturated fat intake drives our cholesterol up much more than excess weight or sloth does.

It just means insulin resistant people should reduce their carbo intake to about 45% of their caloric intake rather than the normally ideal 60% or so. It's also best if most of that 45% is low-glycemic-index foods, or at worst occasionally guiltier foods eaten with at least eat some protein, fiber, and maybe some mono- or unsaturated- fats to slow its digestion and thus its effect on blood sugar. Beans, olive oil, nuts or a dash of lean meat are an excellent adjunct to these high-glycemic foods because they add protein, fiber, maybe a little fat, and/or lots of flavor to a meal, and they reduce the sugar spike of straight carbos. Chemical intervention is usually necessary only for those who refuse to lose weight and exercise enough to lower their insulin resistance.

BTW, some of the diet books claim carbos and the resulting insulin make us fat. That's Bogus Science, aka BS. Nothing's changed; it's still CALORIES (minus exercise) which make us fat. As Dr. Reaven says, "Nobody has yet repealed the laws of thermodynamics." If anything, insulin resistance should make us lose weight because it impairs fat storage.

Get your glucose levels checked (via the same simple fasting blood sample used to measure your cholesterol properly). If your fasting glucose level is over 110, buy Dr. Reaven's book, "Syndrome X: Overcoming the Silent Killer That Can Give You a Heart Attack". It's front and center in every major bookstore in the country, near Dr. Atkins' and the carbo addicts' books. The main difference, from what I've read, is that Reaven's book belongs in the medical section, whereas those others may fit better in the science fiction section. If you're going to buy sci fi, you may as well buy Battlefield Earth instead. At least it obeys the Hippocratic oath; it does no harm. And get the book; it's a hundred times better than the movie.

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