A problem with our current diagnosis of metabolic health is our obsession with monitoring glucose and viewing as the metric that matters. In the example below we have the two time points. The first is Insulin Resistance or pre diabetes and important to note the glucose is normal but insulin is elevated they are not the same thing we fail to appreciate that they do not go hand in hand that if glucose is low insulin is low or glucose is high insulin must be high. For an historical point- Dr Joseph Kraft a pathologist developed the kraft test- an Oral glucose tolerance test with insulin assessment. Testing over 15,000 patients he found that in over 50% of confirmed diabetes cases they had normal glucose levels but high insulin. This would have been missed if we only test blood glucose levels. Glucose is obsessively the marker we concentrate on with diabetes but it shouldn’t be! We have the ability to measure insulin, so why don’t we? We see here that insulin is highlighting the problem potentially 10 years before we see a change in blood glucose levels. This is the potential if we come away from a glucose centric paradigm. How is hyperinsulinemia caused? The first eating pattern of 3 meals a day is more of an uncommon eating pattern we see today. Every time you eat this is the reciprocal insulin response across the day.
Compare that to the more common pattern of breakfast, mid morning snack, lunch, mid afternoon snack, dinner and possibly dessert. This causes many more insulin responses and with a insulin sensitive person this can be managed for a while. But for an insulin resistant person the insulin never comes down it is constantly elevated. Therefore, we can now see that hyperinsulinemia can be a consequence of insulin resistance and also a cause. Its a vicious cycle accelerating the problem until the person changes their habits. How do we correct insulin resistance? If hyperinsulinemia is the primary cause then lowering insulin needs to be the solution. We do that through the foods we eat and by managing these macro nutrients. Compared to drugs it doesn’t come along with side effects it actually has side benefits to all our metabolic markers and our waistline! How do Macro nutrients affect Insulin? Currently according to the global nutrient database this is the proportion of macro nutrients we are eating around the world, Carbohydrates were the major contributor to energy availability (70·5%), followed by fats (17·4%), and protein (10·5%). Fat does not increase insulin, there is no study that shows that according to Dr Ben Bikman PhD. Protein has a small effect but carbohydrates have a large effect (18). In the image below this is the effect size in a slightly different view. This is not declaring a war on carbs because the type of carbohydrates do matter, but when we acknowledge that hyperinsulinemia is the cause of insulin resistance, one of these diets is going to work much better at removing the offending agent. When we eat these macro nutrients there is a corresponding blood molecule. In diabetes (type 2) which is just a prolonged insulin resistance, which of these nutrients in the blood is the body struggling with. Glucose is the one we obsess over the most and the one we are all eating the most of. “If lifestyle is the culprit, it is also the cure! The food we eat is causing or can cure these metabolic issues! When we look through an insulin lens, we appreciate we just need to lower the insulin by managing our macro nutrients, control carbohydrates, prioritise protein, don’t fear fat, and maybe frequently fast. This can literally cure the problem.” Dr Ben Bikman
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About 5 years ago my health was troubling me as I found it difficult to think
straight, formulate my words, had a lack of energy, motivation for exercise and I was putting on weight. This didn’t make much sense to me as a former athlete and with my job now as a strength and conditioning coach, so I am active all day everyday. I decided to get some blood work done and my triglycerides and HDL were out of the accepted range, which is doubly troubling considering these reference ranges are based on a sick population as it is. This lead me to look for answers and I found those answers and that is what I am going to discuss in this article from my knowledge through my learning through the Nutrition Network which I am now a nutrition Network advisor and the knowledge of many exceptional researchers, clinicians around the globe that have highlighted the impact of insulin resistance on our bodies and brain. Metabolic syndrome has been described as anyone having three of these five symptoms, increased waist circumference, increase in blood glucose, high blood pressure, high triglycerides and low high density lipid proteins or HDL the so called good cholesterol. In the UK currently it is said that 33% of adults have metabolic syndrome (1), this is not just a UK problem this is a global problem with high rates of insulin resistance in south east asia, the middle east, pacific islands, USA and Mexico, which showcases the prevalence of the problem. It is estimated that nearly a billion people suffer from Insulin Resistance across the globe, (2) yet it is not routinely screened. In the UK the problem actually could be a little worse, high blood pressure or hypertension is said to affect 58% of the population (3) which is a critical part of metabolic syndrome and usually the first sign that something has gone array. While we are not always measuring the other signs, we are always measuring blood pressure when we see a GP. So if 58% of the population have hypertension might that mean that 58% have insulin resistance. Why that connection? Metabolic syndrome used to be called Insulin Resistance syndrome which does a much better job at explaining what is causing the symptoms, much better than the vague term metabolic syndrome. So if 58% of people in the UK have hypertension its not much of stretch to suggest they have Insulin Resistance which is presenting itself as high blood pressure. Insulin Resistance is at the root of the common diseases we are seeing today such as Heart Disease, as it is fundamental in contributing to heart Disease and the damage to the vascular system, it would be very uncommon not totally impossible for someone to have heart disease without insulin resistance and hypertension plays into that. With Cancer, some cancers are not caused but made worse by Insulin Resistance, as it accelerates the growth of the cancer cells. Fatty Liver, the most common liver problem across the world, directly caused by insulin resistance and the insulin promoting the growth and the production of fat within the liver. Type 2 diabetes, with the high levels of insulin known as hyperinsulinemia is trying to manage the high blood sugar levels and causing more cells to become resistant, and Body Fat, you cannot make fat cells grow without insulin being elevated, regardless of calories consumed. In addition to these big 5 killers or problems, we have some that range from similarly lethal and tragic like dementia and Alzheimer’s disease, being the most common form and even stroke one of the most top expenses of the NHS. Then less lethal but very relevant to a population and particularly heart breaking for a couple we have the most common forms of infertility. The most common in women PCOS (more appropriately called metabolic infertility) insulin directly affects estrogen production from the ovaries and in Men Erectile Dysfunction which may be the first clinical sign of Insulin Resistance in otherwise healthy men. Due to what IR is doing to the blood vessels. The hope is that a person who is taking medications for hypertension, diabetes, migraine, and fatty liver etc doesn’t believe that they are all individual problems they are in fact the symptoms of the same root cause. Once we know this we can then impact that root cause and as Dr Robert Lustig has suggested in his great book Metabolical, the root cause is not druggable but is foodable. This is because these chronic diseases are disease of the mitochondria the power house of a cell that uses food to produce energy. So while treating the symptoms of these diseases with drugs it never gets to treat the mitochondria, only food can do that. How do you know if you have insulin resistance? Do YOU have high blood pressure, type 2 diabetes or gestational diabetes, PCOS (women), Erectile dysfunction (Men), fatty liver disease, or skin tags and dark patches on the back of the neck or under the arms (acanthosis nigricans). The skin can be a window into the metabolic soul! If you answered yes to anyone of these then you likely have insulin resistance. These are signs of an underlying metabolic problem, but most are undiagnosed! This is why the problem is likely much worse because you could have someone with these skin tags and acanthosis nigricans and have a normal blood sugar or blood pressure and therefore they are not considered to have any issues metabolically. (1)https://www.nhs.uk?conditions/metabolic-syndrome/ (2) PMID: 29480368 (3) https://www.gov.uk/government/publications/health-matters-combating-high-blood- pressure/health-matters-combating-high-blood-pressure Taylormade Performance and rehabilitation teaches Modified Pilates following The Australian Physiotherapy and Pilates Institute (APPI). This method combines traditional Pilates with the most current research into spinal stability. It breaks the exercises down into clearly defined levels to produce a gradual progression of load and control. Using this framework of exercises, we operate in the knowledge that our practices are up to date, safe and effective ensuring the most appropriate outcome for every client. This may be performance related, muscle toning, rehabilitation, posture or just to be able to move more efficiently and free of pain and stiffness. Whatever the objective our program has a proven track record of success.
There are many forms of Pilates from Mat work exercises that utilise the control, resistance and mobility of the body alone to exercises using the reformer, a specific piece of equipment that provides external resistance to exercises. There are various smaller apparatus such as the Pilates Ring, the small over ball, the foam roller, the resistance band and the Barrel to name a few. The modified Pilates method that we practice also provides a host of diversity by creating levels of intensity for each of the original 34 Pilates exercises. The variety and diversity that can be achieved with Pilates makes it such a successful mode of exercising in a group. It allows the instructor to adapt and create a variation of an exercise to cater for different abilities within the same class without setting up completely different programmes for each member of the group. It also provides an opportunity for the participant to witness improvement and progress in their practices. Our tailored approach that underpins all our services is carried through to our Pilates groups. We can achieve this by keeping our Pilates groups small (on average between 4-6 participants), whilst using the modified Pilates approach and the variations it offers. The individual induction we recommend prior to joining a class provides an insight into the participant’s ability, control and experience ensuring they are safely whilst suitably challenged. Pilates is recognised as a beneficial activity for promoting wellbeing. Its exercises focus on a mind and body connection promoting concentration on body awareness and visualisation of movement. It utilises breath work to enhance the performance of exercises. At Taylormade we have experienced further wellbeing benefits expressed by our clients that attend group Pilates. Some groups have practiced together for over six years. This time each week provides opportunity for both new acquaintance and conversation to develop as well as opening up a time for old friends to socialise whilst carrying out their Pilates. Our informal sessions always provide a relaxed and welcoming environment. Pilates is becoming increasingly recognised in the world of sport with top athletes such as Andy Murray, Christiano Ronaldo, Maria Sharapanova, Chris Robshaw and Lebron James all providing testimonies to the discipline.
Pilates can impact an athlete in many ways, 5 key areas are :
What is Pilates:
Pilates is a form of exercise which concentrates on strengthening the body with an emphasis on core strength. Pilates also focuses on the mind-body connection. While doing the various exercises your mind needs to be constantly aware of your breathing and the way your body moves. This form of exercise was developed by Joseph Pilates in Germany where he was a carpenter and gymnast. He invented Pilates as an exercise program for injured dancers and soldiers while living in the UK. Joseph Pilates believed that physical and mental health were closely connected. In the 1920’s he immigrated to the US and opened a Pilates studio in New York. Originally this form of exercise was called Contrology. Today it is widely practiced by many in all aspects of life and its key principles are transferred into our everyday life.
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