A modern epidemic

Type 2 diabetes stalks those who overeat and under-exercise.

Humans are programmed to be lazy and eat a lot when the opportunity arises. Dr. Lorraine Lipscombe, an endocrinologist at Women’s College Hospital in Toronto and research fellow at the Institute for Clinical Evaluative Sciences (ICES) says this sloth and gluttony helped early humans save energy while coping with the uncertainty of when they’d have their next meal.

She told attendees at the Women’s Health Matters Forum and Expo in Toronto in January 2008 that people today eat too much food and live much too sedentary lives. As the pounds pile on, there’s a growing risk of developing type 2 diabetes.

Type 1 diabetes is an autoimmune disease that usually appears in children or adults under 30. Blood sugars levels rise because their bodies don’t produce insulin. Type 2 diabetes results from the body’s resistance to insulin and accounts for 90 to 95 per cent of diabetes cases. It usually strikes people middle-aged or older.

Poorly controlled diabetes can lead to blindness, kidney failure, nerve damage, heart disease and stroke. Lipscombe said that in Ontario, diabetes was responsible for one third of heart attacks and strokes, two-thirds of amputations, and half of the patients starting kidney dialysis. It’s putting an increasingly large burden on the health-care system.

Lipscombe’s research found that by 2005, nearly nine per cent of Ontario’s 9.3 million people were living with diabetes. In fact, the prevalence of diabetes in the province had surpassed the predictions of the World Health Organization (WHO) for 2030. She noted rising rates in the 20-49 age group, a worry because diabetes increases the risk of birth defects.

Are you a pear or an apple, she asked? Apple-shaped people have disproportionately large waistlines because they have visceral fat packed around their internal organs. “This fat is metabolically active and is more harmful,” she noted, adding that men’s waists should measure less than 40 inches and women’s less than 35 inches. Obesity is one risk factor that people can do something about, Lipscombe said.

Other risk factors include being over 45 years of age, a family history of diabetes, living a western lifestyle, or being of South Asian or African descent.

“We eat out too often,” she commented. The trouble is this tasty food is loaded with fat and salt. “Portions are too big,” she said. The average adult needs less than 2,000 calories per day yet entrees alone from many family restaurants are commonly over 1,000 calories, she pointed out. And then there are appetizers, desserts and beverages!

We’re often car-dependent to get to our homes in suburbia. As minutes are spent in the car, there’s a corresponding rise in weight. Those excess pounds sneak on slowly, but one to five pounds a year can add up over 20 years to 20 to 100 pounds.

Lose weight slowly, she advised and adjust your lifestyle so that the weight stays off. As well as cutting down on portion size and minimizing fast food, she also suggested stopping “mindless” eating – nibbling on candies, for example, just because the dish is within reach.