Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 1
www.angelalasallemd.com
Not for profit, all about you.
Protecting Your Waistline:
The Skinny on Vitamin Dand the Insulin Connection
Angela LaSalle, MDMedical Director
Integrative Medicine andParkview Women’s Health Center
Michele Helfgott, MD, FACOG
www.angelalasallemd.com
Not for profit, all for you.
Board certified OB/GYN20 years experienceFellowship in Anti-Aging and Regenerative Medicine
Committed to finding the root cause of disease, Dr. Helfgott treats issues associated with:
Menopause, perimenopause, Autoimmune diseaseGastrointestinal issues. Bio-identical hormone replacementAssists with nutritional counseling and exercise
• .INTEGRATIVE MEDICINEfocused on you
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 2
Workshop Goals
www.angelalasallemd.com
Role of Vitamin D as a preventative strategy in the fight against obesity, diabetes and chronic disease.
Understand screening tests for Vitamin D deficiency
Risks and benefits of Vitamin D supplementation
Role of insulin in obesity and diabetes
Review basic recommendations to reduce insulin levels.
Obesity: How Big is the Problem?
www.angelalasallemd.com
Allen County
2004: 24.7%
2012: 33%
Overweight is BMI > 25%
Obesity is BMI > 30%
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 3
Diabetes: How Bad is the problem?
www.angelalasallemd.com
The CDC estimates that by 2050, the incidence of Type 2 DM may be as high as 33%
Vitamin D Deficiency: Who has it?
www.angelalasallemd.com
75% of Americans have low levels(Archives of Int. Med 3/09)
12.1% of infants and toddlers
Higher incidence in dark skinned individuals:African Americans, Hispanics, Indian
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 4
Causes of Vitamin D deficiency
www.angelalasallemd.com
• Lack of sunlight
• Ethnicity – Melanin in dark skin blocks light stimulation
• Aging
• Renal Disease
• Obesity
• Genetic Variance in Vitamin D receptors
Common Denominator
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Insulin
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 5
How does Insulin Work?
www.angelalasallemd.com
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 6
Diabetes: What causes it?
www.angelalasallemd.com
Type 2 diabetes is a miscommunication between multiple organs:
IntestinesPancreasLiverBrainCells
It is not just a high blood sugar, but rather multiple biochemical abnormalities.
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 7
The results of insulin dysfunction
www.angelalasallemd.com
It isn’t just about the blood sugar.Higher insulin results in
inflammationhigh blood pressureweight gainlipid disordersincrease in risk of heart attack, stroke, canceretc.
Abdominal Fat is a biochemical problem!
Role of Vitamin D in Insulin Release
www.angelalasallemd.com
Key word is CALCIUM
Vitamin D is responsible for the Calcium balance in the body.
Release of Insulin requires the action of Calcium in the Beta Cell of the Pancreas.
Action on other Vitamin D receptors in the cells of the body still under investigation.
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 8
Vitamin D Sources
www.angelalasallemd.com
• Fortified foods: most common ergocalciferol or vitamin D2
• Vitamin D3 or Cholecalciferol is 66% better absorbed than D2
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 9
Vitamin D Sources
www.angelalasallemd.com
Sunlight is best source.– UVB light 270-300nm
– Body makes 10,000 iu with 20-30 min sunlight
– Toxicity from sun not possible• After body makes 20,000 iu same
light begins degradation of vitamin D
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 10
Symptoms of Deficiency
www.angelalasallemd.com
• Depression
• Fatigue
• Increased infections
• Muscle aches
• Loss of bone density
Diseases with Vitamin D deficiency
www.angelalasallemd.com
• Rickets
• Osteomalacia, Osteopenia, Osteoporosis
• Psoriasis
• Peripheral Vascular Diease (80% may be deficient)
• Diabetes (both type 1 and type 2)
• Cancer
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 11
Diseases Under Investigation
www.angelalasallemd.com
• Multiple Sclerosis
• Rheumatoid Arthritis
• Parkinson’s
• Alzheimer's
Metabolic Functions of Vitamin D
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• Affects insulin signaling
• Affects activation of enzymes
• Affects neurotransmitter production
• Affects function of macrophages
• Affects ability to fight infections
• Affects inflammatory cascades
• Affects cell growth
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 12
Vitamin D and Cancer
www.angelalasallemd.com
• 1000 IU (D3) decreased cancer:– Colon by 50%
– Breast and ovarian by 30%
– Pancreatic by 43%
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 13
Medication Effects on Vitamin D
Vitamin D Toxicity
www.angelalasallemd.com
• Signs consistent with high calcium levels– Muscle Aches
– Loss of appetite, nausea
– Protein in urine
– Kidney stones
– Increased thirst and urination
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 14
Caveats
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• Have Vitamin D levels checked
• Rule out magnesium deficiency
• Supplementation more than 1000iu daily should be followed by physician
• Monitor Vitamin D, parathyroid levels on therapy.
• Report any side effect of supplementation to physician.
Recommendations to Reduce Insulin
www.angelalasallemd.com
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 15
Table Sugar
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Table Sugar
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Sugar:
The Bitter Truth by Dr. Robert Lustig Pediatric EndocrinologistYouTube
DVD: Sweet Suicide, A Documentary by Nancy Appleton, PhDSweet Suicide is a 60-minute documentary produced in 2009 by Nancy Appleton, PhD, about the health dangers of sugar. Appleton is America's most well known anti-sugar expert and author of Lick the Sugar Habit, which is still selling strong after 30 years in print.
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 16
Sugar Makes Fat
www.angelalasallemd.com
Study:Healthy med students were given a high fructose diet for 6 days
• Triglycerides doubled
• Free fatty acids in the blood doubled
• Insulin levels increased
• 5x more fat cells
Sugar Makes You Old
www.angelalasallemd.com
Sugar is implicated in all of the degenerative disease processes:
Heart DiseaseDiabetesAuto Immune DiseaseArthritisCancerImpotenceHormone disruptionsand….
Wrinkles
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 17
Watch Your Fluids
www.angelalasallemd.com
Recent studies have shown that drinking one soda a day increases your risk of heart disease by 20%
Did you know that 4 grams of sugar equals approximately one teaspoon?
Nutrition Label – Coca Cola
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Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 18
Sober Thought
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Some brands of baby formula contain up to 43% corn syrup and 10.3% sucrose
Coca Cola contains 10.5% sucrose
Sweeteners
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Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 19
Nutrition Label – Diet Nestea
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Diet Soda and Weight Gain
www.angelalasallemd.com
University of Texas Health Science Center in San AntonioSan Antonio Longitudinal Study of Aging (SALSA)
70% greater increase in waistline (9.5 yrs later)
2 or more sodas a day resulted in 500% more weight gain than non soda drinkers
Results adjusted for diabetes status, physical activity and age.
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 20
Artificial Sweeteners
www.angelalasallemd.com
Hundreds of times more sweet than sugar
Body preps for sweets and releases excess insulin
Blunts the neurotransmitters in brain that help you feel full
Result is you feel less satisfied, take in more calories and the body stores more fat due to higher insulin levels.
Implicated in inflammatory symptoms in some people
Overhaul Your Fluids
www.angelalasallemd.com
Eliminate all soda
Look for any artificial sweeteners in your beverages
Increase your water intake
Limit coffee to no more than 2 cups a day
Eliminate juices…eat the fruit instead
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 21
Eliminate the Sweets
www.angelalasallemd.com
Remember that flour also breaks down to sugar…decrease the baked goods
Try keeping a food diary to learn your habits
Evaluate what you put in your beverages…creamers, flavors and look for sugars and sweeteners.
Start reading food labels for hidden sugars/sweeteners
Remember 4 grams of sugar equals a teaspoon
Balance any sugar intake with protein or fiber
Increase Your Vegetables
www.angelalasallemd.com
Good source of nutritients: antioxidants, phytonutrients, minerals
Good source of fiber
Helps hydration
Good source of carbs without high insulin response
Balance your plate with lean proteins (fish, chicken, lean cuts beef)
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 22
Exercise
www.angelalasallemd.com
30 minutes daily
Decreases insulin resistance in skeletal muscle
Decreases inflammation
Rehearses the neurovascular connections of the body
All disease preventative
There is no substitute for the benefits of exercise!
Talking Points with Your Doctor
www.angelalasallemd.com
Ask for Testing:25-OH Vitamin DFasting Glucose
< 95 is normal> 110, then glucose intolerant> 126 Diabetes
Fasting InsulinFasting Lipids
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 23
Talking Points with Your Doctor
www.angelalasallemd.com
Measurements:WeightBlood PressureBMIWaist to hip ratio
0.8 or below, is normal
Supplementation and Monitoring
Q & A
www.angelalasallemd.com
Parkview Women's Health Center Seminar Series
11/13/2012
Angela LaSalle MD 24
Angela LaSalle, MDAngela LaSalle is board certified in Family Medicine with a
fellowship in Integrative Medicine. She is a guest and keynotespeaker on a variety of medical topics and women’s health issuesand provides interviews for radio and print media.
A graduate of Indiana University School of Medicine, she received herfellowship in Integrative Medicine through the University ofArizona, a program founded by Andrew Weil, M.D.
Her practice includes assessment of thyroid, adrenals, treatment ofmetabolic syndrome, bioidentical hormone replacement as well ascomprehensive nutritional assessments. She provides integrativehealth care services for patients with thyroid, diabetes, metabolicand menopausal issues. A strong believer that inflammation is theunderlying cause of many diseases, she also incorporates nutritionand stress management into her treatment arsenal.
Dr. Angela LaSalle is Medical Director of Parkview Physician’sGroup Integrative Medicine clinical division and Medical Directorof the Parkview Women's Health Center located at the newParkview Regional Medical Center on its Parkview NorthCampus.
www.angelalasallemd.comVisit her web site: