Type 2 Diabetes: Activating the Master Metabolic Switch

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Type 2 Diabetes: Activating the Master Metabolic Switch
“Lifestyle changes that include healthier diet and routine physical exercise help older overweight and obese adults with type 2 diabetes improve glucose control, body composition, physical function and bone quality”. This was headline news released from The Endocrine Society on April 1, 2016, revealing the preliminary findings of an ongoing clinical trial. The study did not mention key aspects of how a master metabolic switch is activated with certain foods and nutrients in the diet and physical activity. This master switch is called AMPK. If you have blood sugar problems, metabolic syndrome, or any number of other disorders, you need to learn how to healthfully activate this switch.

[Jump to: Nutritional Options]

The Endocrine Society found that participants in the study, 65 to 85 years of age, who engaged in 90 minutes of aerobic and resistance exercise three times a week and learned healthier eating habits improved their health. After six months, participants had improved their lean body mass, hemoglobin A1C levels, bone density, and peak aerobic capacity. The lead research dietician and study author, Alessandra Celli said “If our results are confirmed, these encouraging findings may be used to formulate concrete recommendations about healthy lifestyle changes in older diabetic patients. Long-term studies involving a larger sample are needed to follow up on these results and examine underlying mechanisms”. Further details of exercise and dietary habits were not released.

As the obesity and diabetes epidemic affects hundreds of millions of people around the globe, by the time research stops flogging the idea that healthy diets and physical activity or “use it or lose it principle” is thoroughly agreed upon, it will be too late for many. The common sense, well-established treatment of type 2 diabetes is diet and exercise. Clean up the diet. Get rid of the junk food. Get active and move. We have lost sight of these fundamental principles with the busyness of life, processed and GMO food, and “sitting is the new cancer” sedentary lifestyle.

The study released on April 1 may seem even a bit foolhardy in light of the terrible healthcare trend we face and the needless waste of enormous amounts of dollars studying what is already known and globally recommended. We can however, dig considerably deeper and come up with some clinical pearls that are well worthwhile and empowering for persons struggling with diabetes, obesity, and metabolic syndrome management. Many of these skills, behaviors, and tools can be applied today. Some tools mentioned are standards that Wellness Resources has advised for many years. Other tools reflect cutting-edge information with AMPK, the master enzyme switch that turns on metabolism and energy production and is grossly defunct in diabetes and metabolic syndrome.

The Leptin Diet


The first key to activating AMPK is to follow the Five Rules of The Leptin Diet:
1. Never eat after dinner. Finish eating dinner at least three hours before bed.
2. Eat three meals a day. Allow 5-6 hours between meals. Do not snack!
3. Do not eat large meals. Finish a meal when you are slightly less than full.
4. Eat a high protein breakfast. Aim for 20-30 grams of protein at breakfast.
5. Reduce the amount of carbohydrates eaten. Limit, don't cut out carbs.

If you have never read The Leptin Diet or Mastering Leptin, now is the time to start. If it has been several years since you read one of these books, refresh yourself and you may find that you have come a long ways, but forgot some key findings.

AMPK and Blood Sugar


AMPK (5’-adenosine monophosphate-activated protein kinase) is a master enzyme that is directly involved with sensing energy levels within the cells. AMPK is normally turned on when cellular energy levels are low. When fatigue occurs and low energy exists, it sends signals to stimulate the uptake of blood sugar into skeletal muscles, burn fat for fuel with the adipose tissue and other tissues, and reduce fatty liver stagnation problems. AMPK is found in all cells of the body, especially the hypothalamus, liver, muscles, adipose tissue, and pancreas. Research shows that the AMPK enzyme activity is dysregulated in people and animals with type 2 diabetes and obesity.

Failure of AMPK leads to reduced exercise tolerance, increased fatigue, and higher levels of oxidative and mitochondrial stress. It provokes higher levels of cellular inflammation. Not addressing poor AMPK activation may lock in the problem and put one at higher risk for other disorders, because it is a key switch in cellular metabolism. AMPK switches cellular metabolism from the anabolic to catabolic mode, burning foods to make ATP or energy. It restores the energy balance after stressors that cause energy depletion.

AMPK Problems


Studies show that faulty AMPK activation has grave implications not only for diabetes and metabolic syndrome, but also cancer. Enormous amounts of research are being done to understand the link between AMPK inactivity, poor metabolism and cancer, thus leading to key targets with drug development and nutraceuticals. It is well established that many types of cancers are related with obesity, with as many as 15-20 percent of all cancer death attributable to obesity and poor metabolic fitness. Cancer is the second leading cause of death in the US. This link between diabetes, metabolic syndrome and cancer depends in a large part on AMPK function. Scientists are researching ways to activate AMPK in a healthy way to prevent and even medically treat cancer, diabetes, and obesity.

AMPK has been deactivated in other disorders like Chronic Fatigue Syndrome and Fibromyalgia, cancer and inflammatory disorders, and neurodegenerative disorders like Alzheimer’s disease, Parkinson’s, Huntington’s, ALS, and stroke.

AMPK Activators


Knowing what activates AMPK is primary in turning the switch on with fuel burning and energy production. At the core of this is exercise and calorie restriction. Exercise in particular is regarded as perhaps the most powerful physiological activator of AMPK. Both high intensity and low intensity muscle contractions stimulate AMPK, which then leads to burning of blood sugar and fatty acids to make ATP. Evidence, however, suggests endurance types of exercise activate AMPK more so than resistance (weight lifting) or short duration (running sprints) exercise. Strength training and short burst activity rely on phosphocreatine and glycogen as the main energy source. Endurance exercise relies on oxidative metabolism, burning of glucose and fats and requires high activation of AMPK.

Several natural compounds and hormones help activate AMPK. Incorporate the natural compounds with diet or supplementation and balance hormones with The Leptin Diet. Polyphenols, which are found in plant-based fruits (grapes, pears, apples, cherries, and berries), vegetables (particularly broccoli, onion, and cabbage), beverages (coffee, green and black tea, red wine) and legumes provide powerful diabetes protection. Some of these compounds are directly known to help activate AMPK.

Resveratrol, a natural polyphenol found in red wine, has been shown to activate AMPK. Studies show that resveratrol stimulates AMPK within the liver, muscles, and brain. Treatment results showed that resveratrol stimulated blood sugar uptake into muscle cells to be burned for fuel. It then produced energy, helped make new mitochondria in muscles and the liver, and reduced fat accumulation in the liver.

Quercetin is another compound that has been shown to activator AMPK. Quercetin is naturally found in apples and onions. Green tea extract, capsaicin (the active component in peppers), and even willow bark/salicylate (aspirin) activates AMPK.

Olive leaf extract also activates AMPK. New animal research shows that olive leaf extract decreased body weight, fat tissue mass, triglyceride levels, and helped alleviate fatty liver problems in obese rodents that were fed a high fat diet. Their conclusion was that olive leaf extract had important implications in preventing obesity.

Bitter melon, a common Asian vegetable, demonstrates strong antioxidant and hypoglycemic activities. Research has shown that it helps fat metabolism and increases the function of AMPK.

The hormone leptin directly affects AMPK. When leptin is released from fat cells/adipose tissue as a signal that fat stores are adequate, it stimulates AMPK within skeletal muscle tissues. Healthy leptin function within the muscle tissue activates fat burning and energy production. Adiponectin, another adipose tissue hormones like leptin, activates AMPK within the liver. Low adiponectin levels are related with insulin resistance, heart disease, and metabolic syndrome. Healthy leptin and adiponectin enhance glucose uptake and increase fat burning in muscle tissue.

Summary


Preventing and managing type 2 diabetes is indeed related with diet and exercise. However, much greater understanding and tools are needed for management than repetitive news of simply noting that diet and exercise can change type 2 diabetes outcomes. The first lifestyle to embrace is incorporating the Five Rules of The Leptin Diet to manage leptin and adiponectin. This also allows a measure of fasting or calorie restriction that helps activate AMPK.

Physical activity, preferably endurance type aerobic activity is essential. For those who have not engaged in physical activity of any length or duration for sometime, start slow. This includes those who struggle with other chronic illnesses like cancer, Chronic Fatigue Syndrome, and Fibromyalgia that have AMPK problems. If you think you can walk two miles the first time out on a beautiful spring day, but haven’t regularly walked more than 2 - 3000 steps per day, you will need to adjust your expectations. Start with half of what you think you can do.

For those who have been seriously ill, start with 25 percent of what you think you can do. It might just be a walk around the block or down to the mailbox. Doing something is the key. Build on it slowly. If you run into exhausted fatigue and feel considerably worse after the activity, reduce the amount and intensity of the activity and then slowly build on it. You may need to support adrenal health and detoxification if you hit the wall too much with lactic acidbuild-up from physical activity. Extra magnesium, vitamin B1, and PQQ can also help reduce the lactic acid burn and fatigue.

Poorly managed diabetes and metabolic syndrome are serious as they can lead to blindness, neuropathy, kidney failure, Alzheimer’s disease and cancer. Resveratrol, quercetin, green tea extract, olive leaf extract, bitter melon, and other polyphenols can be used to help nutritionally activate AMPK.

Managing a chronic illness that is stable is tough enough once it is established. Don’t ignore the basic principles and succumb to inertia and its deadly consequences. Our bodies are made to move and to have a diet rich in quality fruits and vegetables from all the colors of the rainbow, fibers, proteins, and quality fats. Eat and move like your health depends on it – because it does.

Nutritional Options


Resveratrol – Resveratrol is a polyphenol antioxidant found in red wine. It has been shown to turn on AMPK signals and activate the SIRT 1 gene associated with longevity.

Quercetin – Quercetin is known for its anti-inflammatory, anti-histamine, and antiviral activity and triggers AMPK. It can directly turn on different gene signals that induce cancer cell death.

Green Tea Extract – Green tea extract consumed for thousands of years in Asia is a polyphenol that turns on AMPK. Common other uses for it includes weight loss, blood pressure, liver and prostate cancer, fatty liver problems, and antioxidant protection.

Olive Leaf Extract – Olive leaf extract, often used for its germ killing support, can now be added to the list helping AMPK. It has been used for helping to reduce hemoglobin A1C, cholesterol, gout, and blood pressure.

Bitter Melon – Bitter melon helps AMPK activation and improves insulin function and blood sugar levels. It protects beta cells in the pancreas and reduces oxidative stress to the pancreas.

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