The five factors are interrelated and affect metabolism in four main ways, which are also interrelated and interdependent. The four ways are: the starvation response, altered body composition, carbohydrate sensitivity, and hormone imbalance. I'll go into some of these mechanisms in greater detail later, but basically, here is how these metabolism-altering conditions come about.
CARBOHYDRATE SENSITIVITY
With carbohydrate sensitivity, your blood sugar rises too quickly, and your body does not respond to insulin optimally. Instead of being used for energy, carbohydrates are stored as fat, and as a result your body fat goes up.
As I've told you before, carbohydrates are the preferred form of day-to-day energy in the body; they are normally not stored as fat. Rather, when you eat a carbohydrate food, your body breaks it down into a form of sugar called glucose. In response, your body releases the hormone insulin to "escort" the sugar to the muscle cells, where it is used to produce energy. When you eat a complex carbohydrate, such as beans, lentils, oatmeal, or apples, your body breaks it down into glucose slowly, and insulin is also released slowly form of time-released energy. If, on the other hand, you eat a simple carbohydrate food, such as candy, white rice, or pasta or bread made with white flour, the carbohydrate is broken down quickly into glucose. This causes your insulin levels to rise rapidly in order to transport more glucose into the tissues. The insulin increase is your body's way of getting the blood glucose levels to go down, because too much blood glucose can be harmful. Your body can normally handle occasional overloads of simple carbohydrates and store them as extra glucose rather than fat. But many people have abused their systems for so long through either simply eating too many refined carbohydrates or the factors discussed below that their bodies learn to go against nature. Their metabolisms learn to store carbohydrate as fat, whether it is simple or complex, eaten in moderation or excess. It can get to the point where even a balanced meal of chicken, Italian bread, some potatoes, and a vegetable doesn't get metabolized correctly. This meal in and of itself isn't fattening. However, it is possible for you to become so sensitive to the bread and the potatoes that you deposit most of what you have eaten even the carbohydrates and protein as body fat. And if you eat a piece of bread or a small plate of pasta, your body will react as strongly as if you had eaten a piece of cake and send your insulin levels soaring.
Because this inability to metabolize glucose properly is triggered by an abnormal response to carbohydrates, this condition is called carbohydrate sensitivity. It is also sometimes known as insulin resistance because the cells in your body resist insulin's efforts to transport glucose, no matter how much insulin your body produces. Other terms you may hear are Syndrome X, hyperinsulin-emia, and metabolic dysglycemia. No matter what you call it, the consequences go way beyond weight problems. This is, in fact, a pre diabetic state. So, if you aren't upset enough that you are fat, let me scare you by talking about the next stop on the train for you, which is diabetes. Furthermore, carbohydrate sensitivity alters your metabolism of blood fats and increases cholesterol events that are correlated with heart disease, hypertension, and many forms of cancer. The causes of carbohydrate sensitivity are garbage in (eating sugar and other highly refined carbohydrates), yo-yo and crash dieting, lack of exercise, and stress.
Garbage In
Your body prefers carbs, but not all carbs are created equal. Carbohydrate sensitivity is usually initiated when you chronically eat excessive amounts of sugar and other highly refined carbohydrates. This puts a strain on your insulin escort system. Eventually, the constant spiking of glucose in the blood and the resulting insulin surge will create a blunted response in the cells, and they will not allow the glucose to enter. Often my patients have a long history of overeating even gorging on sweets and white bread or huge plates of pasta. Our sweet tooth is the main culprit in the phenomenal surge of diabetes in this country an increase that the Centers for Disease Control and Prevention say "signals the unfolding of an epidemic." In addition, sweet foods are often loaded with saturated fat, and this kind of fat has been found to also foster insulin resistance.
Yo-Yo and Crash Dieting
Dieting contributes to carbohydrate sensitivity because of the disastrous effects it has on body composition. The more muscle mass you have, the more storage space you have for glucose. But the more body fat you have, the less storage space you have for glucose, so it must be converted to fat to be stored. In addition, some extreme diets advocate highly refined carbohydrates or saturated fat, both of which lead to carbohydrate sensitivity over time.
Lack of Exercise
As we have seen, lack of exercise leads to a higher proportion of fat compared with lean muscle tissue. The more sedentary you are, the fewer calories (particularly in the form of glucose) you will use up as energy, and the more calories your body will need to store somewhere as fat. Remember, glucose is stored in the muscles, and if you have a low percentage of muscle and a high percentage of fat guess where the glucose has to go? As your body fat levels go up and your body composition changes, you become more carbohydrate sensitive. Because this effect seems so indirect, some of my patients have a hard time understanding how exercise can affect carbohydrate sensitivity. But I assure them and I assure you that one of the most important things you can do to overcome carbohydrate sensitivity is to change your body composition by exercising to preserve or enhance lean muscle mass and lower your body fat.
Chronic Stress
Our bodies are superbly designed to deal with physical danger stress by flooding our muscles with energy to better allow us to fight or flee the unpleasant situation. It does this by raising cortisol levels, which in turn releases glucose from its storage depots and into the bloodstream. Insulin levels also increase so glucose can be escorted from the blood to the working muscles that need it for a burst of energy. But when stress is constant, high glucose and insulin are also constant. Being stressed is almost as if you have eaten a piece of cake, so being stressed on a chronic basis is like eating cake all day long. This creates resistance in the insulin receptors on the cells they simply don't recognize it any more. It's as if they become numb from overkill.
When the stress is physical say you have escaped a knife-wielding bandit or dashed into the street to rescue your toddler from a speeding car your muscles have a chance to use up the available glucose. Once you have caught your breath and your heart has slowed down, your body senses the lack of glucose, and this stimulates your appetite to replace the fuel that has just been burned up. It makes sense that you would especially crave carbohydrates, the body's main source of energy. Unfortunately, most stress today is not physical, and we do not burn up the glucose. But because of the feedback mechanisms and programmed cascade of events that make up the stress response, we do reach for food and it's usually a bag of cookies or something else sweet. Sweet cravings in the face of stress may be nature's way of making sure we replenish the energy we are supposed to be using up. But in these modern times, we are not using up energy as nature intended. Ironically, stress spikes insulin levels as if we ate cake, and then we do eat cake giving the insulin response system a double whammy. Some of my patients have been doing this all day long it's one stressful moment after another accompanied by a steady flow of M&M's, Reese's peanut butter cups, and so on. Is it any wonder they've developed carbohydrate sensitivity?
In addition, as we have seen, high cortisol levels change body composition toward a higher fat ratio, and this further contributes to carbohydrate sensitivity.
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