Atkins Diabetes Revolution (59 page)

Metformin.
An oral drug (brand name Glucophage) used primarily for treating Type 2 diabetes; it reduces the amount of glucose produced by the liver and improves insulin sensitivity.

Microalbuminuria.
Small amounts of protein in the urine.

Mitochondria.
The portion of each cell that is responsible for energy production for that cell.

Mmol/L:
Millimoles per liter, a unit of measure used outside the United States for indicating blood glucose levels and measurements of other specific substances in the blood.

Monounsaturated fat:
Dietary fat with one missing hydrogen atom; found in foods such as olive oil, nuts, seeds, and avocados.

Morbid obesity:
A BMI of 40 or more.

Nateglinide:
An oral drug (brand name Starlix) for treating Type 2 diabetes; it helps the pancreas produce more insulin immediately after a meal.

Nephropathy:
Kidney disease caused by hyperglycemia and/or hyper- tension.

Net Carbs:
The carbohydrates in a whole food that have an impact on your blood sugar, represented by subtracting the fiber grams in the food from the total carbohydrate grams. In a low-carb product, sugar alcohols and glycerine are also deducted.

Neuropathy:
Damage to the nerves, often caused by hyperglycemia.
See also
Peripheral neuropathy.

Neurotransmitters:
Chemicals that transmit nerve impulses across synapses, or gaps, in the brain.

Nondigestible fiber:
Dietary fiber consisting mostly of cellulose from plant walls; also called insoluble fiber.

Omega-3 fatty acids:
A form of polyunsaturated dietary fat found in fish oil, flaxseed oil, and some other vegetable oils.

Omega-6 fatty acids:
A form of polyunsaturated dietary fat found in many vegetable oils.

Oral glucose tolerance test:
See
Glucose tolerance test.

Oxidation:
A chemical reaction that involves combining a substance with oxygen, similar to the process of metal rusting.

Pancreas:
An organ found in the abdomen behind the stomach; the pancreas secretes the hormone insulin and other chemicals.

Partially hydrogenated vegetable oil:
See
Trans fat.

PCOS:
See
Polycystic ovary syndrome.

Peripheral neuropathy:
Nerve damage affecting the feet, legs, and hands; causes pain, tingling, and numbness.

Polycystic ovary syndrome (PCOS):
A hormonal imbalance in women; associated with enlarged or cystic ovaries, it causes irregular menstruation, infertility, weight gain, high blood sugar, and excessive hair growth.

Polyunsaturated fat:
Dietary fat that is missing more than one hydrogen atom, such as corn and soybean oil.

Postprandial blood sugar:
The amount of sugar (glucose) in the blood after a meal.

Prediabetes:
Blood sugar levels that are higher than normal but not yet high enough to qualify as Type 2 diabetes.

Prehypertension:
Elevated blood pressure that is between 120/80 and 139/89. The stage before hypertension.

Protein:
Complex,intricately folded and coiled chains of amino acids. One of the three macronutrients found in foods.

Proteinuria:
The presence of protein in the urine; an indication of possible kidney disease.

Prothrombotic state:
Having blood that is more likely to form a dangerous clot within a blood vessel.

Reactive hypoglycemia:
Also known as unstable blood sugar. A sharp drop in blood sugar following a sharp rise.

Retinopathy:
Damage to the tiny blood vessels that nourish the retina, the light-sensitive area at the back of the eye.

Saturated fat:
Dietary fat that contains as many hydrogen atoms as possible, such as palm and coconut oil. Usually solid at room temperature.

Statin drugs:
Drugs such as atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor) that block the action of HMG Co-A reductase and used to lower total and LDL cholesterol.

Sucrose:
Table sugar; a two-part sugar consisting of glucose and fructose.

Sugar alcohols:
Sweeteners such as manitol and sorbitol that have negligible impact on blood sugar in most people.

Sulfonylureas:
A group of oral medications used to treat diabetes by helping the pancreas secrete more insulin; they include glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Micronase), tolazamide (Tolinase), and tolbutamide (Orinase).

Syndrome X:
See
Metabolic syndrome.

Systolic pressure:
Blood pressure when the heart contracts and pumps the blood; the first,higher number in a blood pressure reading.

Thiazolidinedione drugs:
Oral drugs for treating Type 2 diabetes, including pioglitazone (Actos) and rosiglitazone (Avandia). These drugs improve insulin sensitivity.

Thyroid gland:
A butterfly-shaped gland in the neck that secretes hormones crucial for regulating metabolism.

Trans fat:
Partially hydrogenated or hydrogenated vegetable oil; a manufactured form of fat widely used in baked goods, fried foods, and snack foods.

Triglycerides:
Fats that circulate in the bloodstream and are stored as body fat. Elevated levels are an independent risk factor for heart disease.

Type 1 diabetes:
High blood sugar levels caused by a lack of insulin resulting from destruction of the beta cells in the pancreas.

Type 2 diabetes:
High blood sugar caused by an inability to use insulin properly, and in later stages of the disease, an insufficiency of insulin.

TZD drugs:
See
Thiazolidinedione drugs.

Unsaturated fat:
Dietary fat that has some unfilled hydrogen bonds; polyunsaturated and monounsaturated fats.

Unstable blood sugar:
Blood sugar levels that rise and fall too much, too quickly, or both, as reflected in a more than 50-point drop in one hour on the GTT or a 100-point drop overall. Symptoms include headaches, irritability, mood swings, sweating, and heart pounding.

Very low density lipoprotein (VLDL):
A form of LDL cholesterol associated with an increased risk of heart disease.

VLDL:
See
Very low density lipoprotein.

Waist-to-hip ratio:
The size of your waist compared with the size of your hips. A high waist-to-hip ratio indicates abdominal obesity.

Scientific Studies That Validate the Atkins Nutritional Approach

Until recently, only a handful of serious research studies had looked at low-carbohydrate nutritional programs. Most conventional medical theories,such as the belief that low-carb diets increase the risk for heart disease by raising cholesterol, were based on the simple and unsupported opinion that “you are what you eat.”Now all that’s changing.

In the past few years, 27 studies and two review papers investigating low-carb approaches have been published in peer-reviewed journals, or were presented at medical conferences. (Several longer-term studies are under way.) Some focused mainly on weight loss and others looked at the effect on blood lipid levels such as total cholesterol, HDL (“good”), LDL (“bad”), and triglycerides. Still others looked at inflammation indicators, which are now considered a risk factor for heart disease. And a few looked at the effect of low-carb programs on medication dosages, particularly in Type 2 diabetics.

Some of the studies used only men or only women,and others were mixed. Some included only obese subjects, others included normal- weight subjects, and still others included primarily diabetics. Yet the picture that is beginning to emerge is increasingly clear. There is now an arsenal of hard facts validating the efficacy and safety of controlling carbohydrate intake.

These 27 studies are listed on the following pages.

Bailes, J. R. J., Strow, M. T., Werthammer, J., et al., “Effect of Low-Carbohydrate, Unlimited Calorie Diet on the Treatment of Childhood Obesity: A Prospective Controlled Study
,” Metabolic Syndrome and Related Disorders,
1(3), 2003, pages 221–225.

Brehm, B. J., Seeley, R. J., Daniels, S. R., et al., “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie- Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women
,” Journal of Clinical Endocrinology and
Metabolism,
88(4), 2003, pages 1617–1623.

Dansinger, M. L., Gleason, J. L., Griffith, J. L., et al., “One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease Risk,” presented at the American Heart Association Scientific Sessions November 12, 2003 in Orlando, Florida.

Foster, G. D., Wyatt, H. R., Hill, J. O., et al., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity
,” New England Journal of Medicine,
348(21), 2003, pages 2082–2090.

Greene, P., Willett, W., Devecis, J., et al., “Pilot 12-Week Feeding Weight-Loss Comparison: Low-Fat Vs Low-Carbohydrate (Ketogenic) Diets,” abstract presented at The North American Association for the Study of Obesity Annual Meeting 2003,
Obesity
Research,
11S, 2003, page 95OR.

Gutierrez, M., Akhavan, M., Jovanovic, L., et al., “Utility of a Short- Term 25% Carbohydrate Diet on Improving Glycemic Control in Type 2 Diabetes Mellitus
,” Journal of the American College of Nutrition,
17(6), 1998, pages 595–600.

Hays, J. H., Gorman, R. T., Shakir, K. M.,“Results of Use of Metformin and Replacement of Starch with Saturated Fat in Diets of Patients with Type 2 Diabetes
,” Endocrine Practice,
8(3), 2002, pages 177–183.

Hays, J. H., DiSabatino, A., Gorman, R. T., et al.,“Effect of a High Saturated Fat and No-Starch Diet on Serum Lipid Subfractions in Patients with Documented Atherosclerotic Cardiovascular Disease
,”
Mayo Clinic Proceedings,
78(11), 2003, pages 1331–1336.

Hickey, J. T., Hickey, L.,Yancy, W .S. J., et al.,“Clinical Use of a Carbohydrate-Restricted Diet to Treat the Dyslipidemia of the Metabolic Syndrome
,” Metabolic Syndrome and Related Disorders,
1(3), 2003, pages 227–232.

Kossoff, E. H., Krauss, G. L., McGrogan, J. R., et al., “Efficacy of the Atkins Diet as Therapy for Intractable Epilepsy
,” Neurology,
61(12), 2003, pages 1789–1791.

O’Brien,K.D.,Brehm,B.J.,Seeley,R.J.,“Greater Reduction in Inflammatory Markers with a Low Carbohydrate Diet Than with a Calorically Matched Low Fat Diet,” presented at American Heart Association’s Scientific Sessions 2002 on Tuesday, November 19, 2002, Abstract ID: 2081.

Samaha, F. F., Iqbal, N., Seshadri, P., et al., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
,” New England
Journal of Medicine,
348(21), 2003, pages 2074–2081.

Sharman, M. J., Gomez, A. L., Kraemer, W. J., et al., “Very Low- Carbohydrate and Low-Fat Diets Affect Fasting Lipids and Post- prandial Lipemia Differently in Overweight Men
,” Journal of
Nutrition,
134(4), 2004, pages 880–885.

Sharman, M. J., Kraemer, W. J., Love, D. M., et al., “A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men
,” Journal of Nutrition,
132(7), 2002, pages 1879–1885.

Sondike, S. B., Copperman, N., Jacobson, M. S., “Effects of a Low Carbohydrate Diet on Weight Loss and Cardiovascular Risk Factor in Overweight Adolescents
,” Journal of Pediatrics,
142(3), 2003, pages 253–258.

Stadler, D. D., Burden,V., Connor,W., et al.,“Impact of 42-Day Atkins Diet and Energy-Matched Low-Fat Diet on Weight and Anthropo- metric Indices,”
FASEB Journal,
17(4–5), abstract of the 12th Annual FASEB Meeting on Experimental Biology: Translating the Genome; Abstract ID: 453.3, San Diego, California, April 11–15,2003.

Stern, L., Iqbal N., Seshadri, P., et al., “The Effects of Low-Carbohydrate Versus Conventional Weight-Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial,”
Annals of Internal Medicine,
140(10), 2004, pages 778–785.

Vernon, M. C., Mavropoulos, J., Transue, M., et al., “Clinical Experience of a Carbohydrate-Restricted Diet: Effect on Diabetes Mellitus
,” Metabolic Syndrome and Related Disorders,
1(3), 2003, pages 233–237.

Volek, J. S., Gomez, A. L., Kraemer, W. J., “Fasting Lipoprotein and Postprandial Triacylglycerol Responses to a Low-Carbohydrate Diet Supplemented with N-3 Fatty Acids
,” Journal of the American
College of Nutrition,
19(3), 2000, pages 383–391.