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You Ask, I Answer: Type-2 Diabetes, Excess Weight, & Genetics

type2diabetesWhat do you think of this website?

It claims that overweight is a symptom (rather than the cause) of diabetes, and that diabetes is simply genetic.

– Courtney (last name unknown)
Via the blog

While there is most certainly a genetic component to type-2 diabetes, environmental (AKA dietary) factors determine whether or not this “genetic potential” is ever reached.

Renowned obesity researcher George Bray perfectly encapsulates the delicate interplay between “nature” and “nurture” with this quote:

Genes load the gun, the environment pulls the trigger.

The dramatic surge in type-2 diabetes rates can not be solely attributed to genetics.

According to figures from the American Diabetic Association and the Centers for Disease Control (CDC), adult type-2 diabetes cases in the United States doubled between 1990 and 2005.

Keep in mind, too, that once upon a time type-2 diabetes was appropriately known as “adult-onset diabetes”, since it was only diagnosed in the adult population.

However, according to the CDC, “The incidence of type 2 in adolescents has increased 10 times over the last decade and now constitutes just under 1/3 of new pediatric diabetes cases (it was 2% 20 years ago).”  Genes don’t change over the course of ten or twenty years.

As for excess weight not being a symptom of type-2 diabetes, it goes against the conclusions of hundreds of top-notch research studies.  Not only has excess weight been shown to increase diabetes risk; the loss of excess weight also undoubtedly decreases risk!

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7 Comments

  1. Brandon said on August 26th, 2009

    That is interesting. I’ve hear the pro low carbers say that all the time. They say “Insulin Resistance causes obesity” (direct quote from some pro low carber on nutritiondata.com)

    I’ve always heard (from my nutrition and biochemistry classes) it was the other way around: TNF-alpha and/or IL-6 and other cytokines released from adipose tissue leads to insulin resistance. Which makes sense. Why use carbs for energy when you have plenty of fat to use for energy? Save the glucose for the brain.

  2. Andy Bellatti said on August 27th, 2009

    Coincidentally, most pro low-carbers (ie: Gary Taubes) have never studied nutrition or human physiology yet brand themselves as ‘experts’ who can dissect the research literature….

  3. Courtney said on August 28th, 2009

    While I agree that “genes don’t change over the course of ten or twenty years”, I think that the point she’s making is that there are toxins in the environment (HFCS, BPA, etc) that adversely affect genes. I’m not sure I buy that, but I think it’s an interesting idea.

    What do you think of her argument that rapid sugar level changes cause hunger, which leads to obesity — essentially saying that the problem was there before weight gain?

  4. Andy Bellatti said on August 29th, 2009

    Toxins may affect body systems (ie: reproductive systems, central nervous system,etc.) after continuous exposure, but genes are not quite as susceptible to change. I am not entirely sold on that idea.

    I am not sure why you list high fructose corn syrup as a toxin.

    As for “rapid sugar level changes cause hunger, which cause obesity”, I think that is a flawed argument. Hunger does not cause obesity; overeating causes obesity. Everyone experiences hunger, but not everyone is obese.

  5. Courtney said on August 29th, 2009

    Well, I didn’t list it as a toxin, she did. But I think there are some reputable studies that show HFCS doesn’t interact in the body in the same ways that “natural” sugars do. (See also: leptin)

    I don’t think genes need to change, just to be “activated” by changes in the environment, no? If the changes include toxins, then the genes would react to those, right?

    Then you’re back to eating as a matter of self-discipline. Generally, most people are taught to eat when they’re hungry. ;)

    You might be interested in this:
    http://www.newsweek.com/id/213646/page/1

  6. Andy Bellatti said on August 29th, 2009

    I don’t understand why anyone would list high fructose corn syrup as a toxin. It’s a completely inaccurate classification.

    I don’t think overeating is solely about self-discipline. As I have discussed many times on Small Bites, portions sizes are a troublesome issue, even more so in light of Brian Wansink’s fascinating research which clearly shows that when we are served more, we eat more. In the same way that I do not like the over-simplification of the “obesity debate” as either nature or nurture, I also don’t think overeating is either 100% self-discipline or 100% external factors. It is a combination of both. I would, however, change the term “self-discipline” to “self-awareness.”

    You mention that people are taught to eat when they are hungry, but there are a lot of issues there. Many children are taught to eat “because it is dinnertime”, regardless of their hunger level. Additionally, many parents do not let children have anything to eat an hour or so before dinner “in case they spoil their appetite”, teaching a child that TIME is a ‘better’ hunger cue than their own stomachs!

    There is also a large emotional component to eating that gets mistaken for hunger.

    As for the link you shared. I do agree that fat discrimination is rampant, but I also greatly disagree with ‘fat acceptance’ advocacy groups that say being fat is healthy. Talk to anyone who was, say, 50 pounds overweight and then lost it, and they will tell you how much better they feel physically (aesthetics apart!)

  7. Courtney said on August 30th, 2009

    I absolutely agree that people tend to lose track of when they’re “really” hungry, especially in this fast-paced world. That works both ways though – my husband has absolutely no clue about his hunger, but he just generally doesn’t eat, and so he is very, very thin. If I am out for the day when he is home, I make sure to set out food and then call him and remind him to eat it, because otherwise I’ll get home and he’ll be a bear because he’s so hungry. ;)

    There is some fascinating research about food, and portion sizes, I agree. Have you read David Kessler’s book, “The End of Overeating”? It’s rather scary.

    I think there’s a different between saying being fat is “healthy” (though overweight women are significantly less prone to osteoporosis) and discriminating against someone because they’re overweight. I don’t think someone’s weight should affect their chances of obtaining a job that doesn’t require manual labor, for instance.

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