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Acanthosis Nigricans, Insulin Resistance And Pre Diabetes!

Development of dark, thickened, often slightly raised and velvety patches on the skin could be a sign of a condition called Acanthosis Nigricans. These patches can sometimes be accompanied by itching.

The areas commonly affected are the neck, armpits, groin, elbows, knees, and knuckles.

Acanthosis Nigricans is strongly linked to insulin resistance.

When carbohydrates are digested, they are absorbed in blood as sugar and the blood sugar levels increase.

In response to this the pancreas releases insulin in blood and insulin helps transport the sugar to various tissues of the body and under its influence, the cells of the tissues take up sugar from the blood and utilise it for the energy that they require for their functions.

Under the influence of insulin the liver also stores more sugar for providing energy to the body later.

This lowers the blood sugar and the blood insulin levels.

But when you eat too much sweets or sugary food regularly, the pancreas is forced to produce more insulin to bring down the blood sugar to normal.

After a while the cells of the various tissues stop responding adequately to the insulin and do not absorb sugar efficiently.

This means the cells of the tissues develop insulin resistance.

This causes both, the blood sugar and the blood insulin levels to stay high.

This raised blood level of insulin is called hyperinsulinemia.

To compensate, the pancreas produces more insulin.

Insulin promotes the synthesis of protein and fat molecules and provides the energy to help in cell growth.

Hyperinsulinemia causes skin cells to reproduce more quickly, leading to the characteristic skin changes in development of the condition of acanthosis nigricans.

When the capacity of the liver and the muscle cells to store sugar is over, the excess blood sugar is stored in the fat cells of various fat depots in the body and our weight increases, gradually leading to obesity.

Hyperinsulinemia and the insulin resistance lead to the development of pre diabetes.

People with pre diabetes have higher than normal blood sugar levels which are not high enough to be diagnosed as diabetes.

Fasting blood sugar levels between 110 to 125 (WHO) or 100 to 125 (American Diabetes Association) and glycated haemoglobin or HbA1c levels between 5.7 to 6.4 per cent are diagnostic of pre diabetes.

Blood sugar levels and HbA1c levels higher than this are diagnostic of diabetes.

People with pre diabetes are most likely to develop full fledged diabetes especially if they have strong family history of diabetes, obesity and sedentary lifestyle.

Other conditions in which Acanthosis Nigricans can occur are obesity, PCOD, thyroid disease, especially hypothyroidism and Cushing’s disease and rarely it is associated with some cancers.

The underlying condition in obesity and PCOD that causes these Acanthosis Nigricans patches is insulin resistance.

If you have such patches on the body, please see you doctor and get them diagnosed.

If they are patches of Acanthosis Nigricans you are likely to have insulin resistance and pre diabetes.

You will need to develop healthy food habits, cut out sugary foods and other simple carbohydrates from your food, eat nutritionally balanced food, exercise regularly, reduce your weight, keep stress low and sleep well.

And don’t wait to start all these things till you catch diabetes!

If you start now, you could most likely prevent the development of insulin resistance and pre diabetes and get rid of these patches!

Also read ‘Insulin Resistance And Diabetes’ and ‘Understanding Pre Diabetes’ on this website.

Carbohydrates Are Essential To Health!

Our food is composed of the following nutrients: carbohydrates, proteins, fats, vitamins, minerals and water.

Each of these nutrients have specific roles to play in the functioning of our body.

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Carbohydrates are of two types, viz. simple and complex carbohydrates.

Simple carbohydrates are made up of one or two sugar molecules while complex carbohydrates are made up of long chains of glucose molecules.

When carbohydrates in our food are digested, these glucose molecules are absorbed our in blood and the blood sugar rises.

This glucose provides the fuel energy that the cells of our body need to carry out their functions.

Insulin is the hormone that influences our body cells to take up sugar from our blood to use up for their energy requirements. Insulin is synthesised in the pancreas,

Simple carbohydrates are digested quickly and cause sharp spikes in our blood sugar and force the body to suddenly release more insulin to bring the blood sugar down. The cells of the body take up the extra sugar from the blood and the blood sugar drops down to normal.

Eating too much simple carbohydrates or sugary food over a period of time leads to the cells of the body gradually becoming insensitive to insulin and respond less and less to it and the body is forced to produce more and more insulin to keep the blood sugar normal, causing hyperinsulinemia.

In time the blood sugars stay high in spite of hyperinsulinemia and leads to insulin resistance and eventually to diabetes.

In contrast, complex carbohydrates are digested slowly and provide steady supply of glucose and hence energy to the body, preventing spikes in blood insulin levels, hyperinsulinemia and insulin resistance and diabetes.

So it is consuming too much simple carbohydrates regularly that leads to hyperinsulinemia, insulin resistance and diabetes, not complex carbohydrates.

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Carbohydrates are the primary source of energy of our body. That means majority of the calories we need to carry out our bodily functions have to come from carbohydrates.

They also have a ‘protein sparing’ function.

Proteins have different functions those do not include providing energy to the body.

Proteins are the most important constituents of all the tissues of the body.

They are essential for the growth, development and repair of the daily wear and tear of the body. They are responsible for the immunity and the defence mechanism of the body. They are also essential for the formation of various enzymes and hormones in our body.

Proteins are not a primary source of energy for our body, under normal circumstances. But in case of people on very low carbohydrate – low calorie diets, the proteins in their food are used up as a source of energy and such people suffer from protein deficiency even if there is sufficient protein in their food.

So the second function of carbohydrates is to provide enough energy to the body so that proteins are not used up for energy and they are ‘spared’ to carry out their normal functions.

Foods that are principally made up of complex carbohydrates also provide essential nutrients like fiber, vitamins, especially B vitamins and minerals like iron, magnesium and selenium.

Complex carbohydrates are the only source fibre in our food. Fibre is crucial to digestion. The insoluble fibre in our food adds bulk to our stools, regulates the peristaltic movement of the intestines, facilitates easy passage of stools and prevents constipation.

The soluble fibre in complex carbohydrates dissolves in water and forms a jelly like substance which absorbs cholesterol and sugars and they are cleared out of the body, helping lower the levels of the blood cholesterol and sugar.

Complex carbohydrates contribute to satiety, helping to control appetite and reduce overall calorie intake. Having well balanced food with adequate complex carbohydrates, without of course over eating, helps in controlling weight rather than causing obesity as is often wrongly projected.

Brain function: Glucose is the primary source of energy for the brain. Complex carbohydrates provide steady supply of glucose to the brain cells and this helps in the smooth functioning of the brain and helps support cognitive functions, including memory and concentration.

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Dangers of low carbohydrate diets.

Effects of low carbohydrate diets on health:

Lack of energy: Without adequate complex carbohydrates in our food, energy levels can fluctuate, leading to fatigue and decreased endurance during physical activity.

Nutritional deficiencies: We suffer from deficiencies of nutrients like fiber, vitamins, especially B vitamins and minerals like iron, magnesium and selenium.

Digestive problems: Lack of fibre in low carbohydrate diets causes constipation and this in time can cause haemorrhoids (piles) and fissures and can also lead to development of conditions like diverticulitis and colon cancer.

Obesity: Low carbohydrate diets are essentially based on meat, eggs, fish and milk and milk products like butter, cheese and paneer and nuts.

Barring skim milk and fish, these foods are high in their fat content and hence are high in calories and are more likely to cause obesity.

Presence of high amounts of saturated fats and cholesterol in these foods can also lead to raised levels of LDL cholesterol and total cholesterol can also lead to heart disease and strokes.

Impaired Brain Function: The brain is dependant upon glucose as its primary source of energy. Lack of a steady supply of glucose from complex carbohydrates can result in impairment of cognitive functions including memory and concentration and mental clarity and focus.

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Thus you can see that you can definitely stop eating or avoid eating simple carbohydrates as much as possible, but complex carbohydrates are absolutely essential to health and you cannot stop eating them without serious consequences for your health.

Also read the articles ‘Basics Of Nutrition’ and ’Carbohydrates Don’t Make Us Fat’ on this website.

The Causes Of Milk Indigestion and Their Solutions!

Many people cannot tolerate milk and milk products.

They develop varying degrees of abdominal discomfort, pain, bloating, gases, diarrhoea when they consume milk.

The commonest cause of this is lactose intolerance.

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Lactose intolerance:

Lactose is the major sugar present in milk.

It is composed of two sugars namely glucose and galactose.

Our body needs an enzyme called lactase to digest lactose.

Lactase is an enzyme that is produced in the what is called as the brush border of the epithelial lining of the small intestines of humans and other mammals.

A large number of people lack adequate amounts of lactase and are unable to digest lactose fully and hence suffer from bloating, gases, diarrhoea and abdominal discomfort when they have milk.

Lactase is also available as a food supplement and is added to milk to produce ‘lactose free’ milk products.

People with lactose intolerance can take lactase supplements before consuming milk and milk products or add it to them before consuming them.

A few people may have difficulty digesting a protein in milk.

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Milk proteins:

Milk majorly has two proteins, casein and whey proteins, the former contributing nearly eighty per cent while the latter makes up most of the balance twenty per cent of milk protein.

Casein has two major components, the A1 beta casein and and A2 beta casein proteins

Most buffalo and cow milk have both A1 and A2 variants of the beta casein proteins.

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Milk protein intolerance:

It is this A1 beta casein that a few people have difficulty in digesting fully.

These people may have some abdominal discomfort when they have milk having both the A1 and A2 variants of the beta casein proteins.

But their number is much smaller than the people having lactose intolerance.

Sixty five to seventy per cent of the world population has varying degrees of lactose intolerance while much fewer people possibly suffer from milk protein intolerance.

Some milk variants of both buffalo and cow milk have only the A2 variant and not the A1 variant of the beta casein proteins.

The A2 milk is marketed at a special premium as a milk that is easier to digest and does not cause discomfort like gases and bloating which regular milk causes in some people.

Although there is not enough scientific evidence to support it, the findings are mixed, some people may experience less discomfort with the A2 milk, whether cow or buffalo, than the regular milk.

Other than that there is no special nutritional advantage of the A2 milk over the regular milk.

But if you like it, are more comfortable drinking it and don’t mind paying the premium for it, you can continue to use it.

The A1 variant of beta-casein can be found in cow’s milk from certain breeds like Holstein, while the A2 variant is found in milk from other breeds like Guernsey and Jersey cows.

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The Gir cow:

Currently the Gir cow milk is touted as a highly superior milk and is sold at a considerable premium.

It is quite likely that buying the more expensive Gir cow milk is getting fashionable amongst our urban affluent, not unlike the use of olive oil!

Gir cow milk does have more A2 proteins than A1 proteins.

Some Gir cow milk may have only the A2 variant proteins but there is no guarantee that the milk you are buying has only the A2 variant and not the A1 variant of the beta casein proteins, unless you have it tested in a specialised laboratory.

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What matters more is that the milk you get comes from buffaloes or cows those graze in open natural pastures, on grass that is free of harmful chemicals and pesticides and the animals are not injected with hormones and antibiotics.

But it is difficult in the current scenario to ensure this.

And buffalo milk is definitely superior to cow milk, you can look for A2 buffalo milk if you like it, tolerate it better or are very keen on buying A2 milk only.

Read more about the nutrition of milk on the link ‘Magical Health Benefits Of Milk’ on this website.