Females, Fit or Fat: The Challenges after Forty Part 3

RoseMarie Pierce, B.Sc. Pharm.

Diabetes, already at epidemic levels in North America, is taking an increasingly severe toll on women and it has a direct link with the weight gain women experience after forty. The World Health Organization estimates the number of people with diabetes will reach an alarming 300 million worldwide by 2025, whereas an estimated 135 million people had diabetes in 1995. Canadian statistics show that rates of diabetes among Aboriginal people are three to five times higher than those for the general population, and two thirds of Aboriginal people with diabetes are women. Approximately 90-95% of North Americans who are diagnosed with diabetes have type 2 diabetes, and 60% of them are women.

What is Type 2 Diabetes?

Diabetes is a chronic condition that interferes with the body’s ability to produce or properly use insulin. Insulin controls the amount of sugar or glucose in the blood and the rate of glucose absorption into the cells. In type 1 diabetes (also referred to as juvenile diabetes) thebody makes little or no insulin due to the destruction of the insulin-producing cells of the pancreas. The vast majority of diabetics are type 2. In this type, the cells become unresponsive to the presence of insulin and the body struggles to make enough insulin to keep glucose levels normal in the blood. Thus, a higher concentration of insulin in the blood is required to achieve the same result. Eventually, the pancreas becomes exhausted and cannot produce enough insulin. Type 2 diabetes occurs when the body loses sensitivity to the blood-sugar-regulating hormone insulin and blood sugar remains chronically high. If left untreated, diabetes can lead to nerve damage, blindness, skin sores, infections, and heart disease and kidney disease.

The number of cases in Canada of type 2 diabetes is estimated to be 2 million. Yet, endocrinologist Dr. Sara Meltzer of Montreal’s Royal Victoria Hospital states that “as many as half the cases of diabetes in Canada go undiagnosed”. However, the issues are much larger and more complicated, for there are a number of impaired glucose conditions, such as hypoglycemia (low blood sugar), glucose intolerance (rapid rise and abrupt fall in blood sugar), and insulin resistance (insulin receptors in cell membranes no longer sensitive to insulin) that tend to occur prior to a type 2 diabetes diagnosis. Characterized by obesity (including a potbelly, abnormal blood lipids and high blood pressure), these pre-diabetic conditions can also cause feelings of exhaustion, disorientation, depression and anger. It is estimated that at least 15% (4.5 million Canadians) of the general population have one or more of these pre-diabetic problems. If a woman remains glucose intolerant and insulin resistant she will have a much more difficult time losing weight, even if she doesn’t develop full-blown diabetes.

What is the connection between weight gain and high insulin?
Refined sugars and refined starchy foods (bread, processed cereal, pastry, potato, rice) raise the body’s blood sugar level substantially and are the biggest contributors to high insulin levels. Insulin is essential for the proper use of the energy contained in carbohydrates, fats and proteins. Insulin is essentially a storage hormone whose main role is to store the excess calories from complex carbohydrates (starches) and simple sugars in the form of fat in case of famine. Also, high insulin levels suppress two other important hormones – glucagons and growth hormone. Glucagons are responsible for burning both fat and sugar; growth hormone promotes muscle development. Insulin also increases appetite. The bottom line is: high production of insulin increases fat storage and causes both muscle wastage and decreased energy levels.

Why are women after forty at a greater risk of developing weight gain?

A high estrogen level, and consequently a low progesterone level (often associated with perimenopausal women), is a powerful activator of fat storage in the hips, thighs, buttocks and abdomen. As long as a woman remains physically fit, a small amount of weight gain in her forties is not associated with life-threatening diseases (diabetes, stroke, cardio-vascular disease). However, if a perimenopausal woman is under chronic long-term stress or is unable to effectively manage stressful situations, fat will also be deposited deep inside the belly, states Dr. Pamela Peeke, a noted expert in the fields of nutrition and stress. During chronic stress, the high levels of cortisol (see Fit or Fat Part 1) stimulate both the appetite center and insulin production. Insulin short-circuits the release of fat and encourages fat storage, specifically inside the abdomen. It is also worth noting that naturally occurring progesterone appears to be able to positively affect blood-sugar levels. However, pre-diabetic conditions have been found in women taking oral contraceptives containing synthetic estrogen and synthetic progesterone. For more understanding of progesterone’s role in female health see “You’re Not Crazy – It’s PMS Part 1 and Part 2.

Researchers have found insulin receptor sites in the ovary. Insulin acts on the enzymes responsible for the ovary producing more testosterone (androgens). It is known that higher than normal androgen levels in a female can raise insulin production; these higher insulin levels then stimulate more androgen production by the ovary. It is still unclear whether excess androgen causes insulin resistance or whether the high insulin level causes the hormonal disturbance. Yet, for some women this can be an insidious cycle that can produce fat and keep on generating more fat.

What are some solutions?

The challenge is to find a way to promote the respect and acceptance of all people no matter what they weigh or how they look, while continuing to support each other against the multi-billion dollar food industries that are clogging our arteries with hydrogenated (trans) fats and stripping nutrients and fiber out of foods by refining and over-processing. Industry also spends billions of dollars getting you to think that you can make up for eating poor-quality “low-fat”, high-sugar processed foods by fortifying them. A good example is the new product, Snickers Marathon. The large multinational, Masterfoods has used the time-proven tactic of product line extension, adding vitamins, minerals and a blend of protein to introduce the same chocolate and gooey caramel flavored candy bar, as a new “healthy food”. Researchers are still in the process of identifying how nutrients interact, and nothing to date can replace the amount, quality and balance of nutrients found in whole organic food.

It has become clear through high-quality scientific research that the type of as well as the quantity, of carbohydrates has significance. It is important at every meal to eat nutritious carbohydrates that provide high-energy and are low on the glycemic index (a measure of how much a carbohydrate food will raise blood sugar levels). This will effectively balance blood sugar levels and prevent weight gain. The latest version of the book, The New Glucose Revolution, offers valuable advice on choosing the best carbohydrates (based on their glycemic index) for weight reduction, controlling hunger pangs, minimizing insulin levels and helping to burn fat.

In the next issue, “Females Fit or Fat Part 4” will look at nutritional supplements and herbs that can support the lowering of blood sugar levels, help reduce abdominal fat, and encourage significant and healthy weight loss.

1. Canadian Research Institute for the Advancement of Women,
2. Health Canada: Aboriginal Diabetes Initiative,
http://www.hc-sc.gc.ca/fnihb/ cp/adi/introduction.htm
3. Association between Eating Patterns and Obesity in a Free-living US Adult Population,
4. Snickers Gets Health Conscious,
5. Peeke P., Fight Fat After Forty, Penguin Books, NY, 2000
6. Wolever, Thomas et al., The New Glucose Revolution, Marlowe & Co. NY, 2003

RoseMarie Pierce, B.Sc.Pharm, earned her degree in Pharmacy from Dalhousie University in 1972. After extensive studies in herbal and nutritional medicine, RoseMarie integrated these disciplinary practices with her pharmacy education to become Canada’s first Holistic Pharmacist.