Cardiovascular disease and insulin resistance
February is heart month, so let’s talk about cardiovascular disease. Cardiovascular disease is one of the most prevalent diseases currently and an important diagnosis to consider as we age. There are many risk factors that play into the development of cardiovascular disease. Lipids (cholesterol) have been the target of most treatments for prevention, however new research has shown that insulin resistance may be the underlying cause of high cholesterol as well as an independent cardiovascular disease risk factor. As naturopathic doctors, we are always looking for the root cause of disease.
Insulin resistance develops due to years of chronically elevated blood sugar levels. When we eat simple carbohydrates, blood sugar levels increase. Our bodies natural response is for the pancreas to secrete the hormone insulin. Insulin works by binding to insulin receptors on cells throughout the body which allows blood sugar to get into our cells for energy. Insulin and exercise are the only two mechanisms for glucose to enter our cells. If the body is continuously exposed to high levels of sugar (simple carbohydrates), our pancreas will start increasing the amount of insulin released in order to maintain a normal level of blood glucose. After chronic exposure to high sugar levels, the cell receptors on which insulin binds will develop a resistance, meaning they need more insulin in order to work. This cycle continues and as the body is no longer able to process the sugar, we see a development of chronically elevated blood glucose levels, known as type II diabetes.
How does this relate to cardiovascular disease? Research on the link between insulin resistance and cardiovascular disease has been extensive. Our bodies clotting mechanism plays an integral role in the development of cardiovascular disease and has been shown to be increased in those with insulin resistance. Arterial wall cells react to high insulin levels and increase the production of clot forming proteins. This increases the risk of clot formation in arteries throughout the body which can lead to heart attack and stroke. Research has also shown that insulin resistant fat cells have a decreased ability to store fat, increasing the concentration of fat (lipids) in the blood.
Insulin resistance can be tested via blood samples. It’s important to not only test blood glucose levels, especially in the early stages of insulin resistance, as the high insulin is trying to manage the blood glucose levels. Naturopathic doctors may test fasting lipids, fasting blood glucose, fasting insulin, hemoglobin-A1c (HbA1c) and C-peptide. Fasting blood glucose and fasting insulin levels give naturopaths an accurate snap shot of what is happening in the blood. HbA1c and C-peptide provide a long term (3 month) look at the glucose and insulin levels respectively. This allows for a comprehensive assessment of insulin resistance.
In order to reduce your cardiovascular disease risk, naturopathic doctors have an array of treatments available through diet and lifestyle modifications and nutritional supplementation. A balanced diet consisting of low carbohydrate, moderate protein and high fat can help regulate blood glucose levels. Exercise is extremely important for overall cardiovascular health, to decrease blood glucose levels and manage insulin resistance. Consider consulting with a naturopathic doctor to help decrease your risk for developing cardiovascular disease.