Tuesday, 20 October 2009

Stress and Diabetes: The case of the Native Indians

Can Stress Cause Diabetes among the American Native Indians? If you had asked this question about ten years ago, to a group of medical/nursing practitioners, the answer would have been a profound NO. Whereas at the same time, a predominantly Native Indians would have said a resounding YES.

That had gotten me to think anthropologically into the high rate of obesity and why Indians become obese so quickly. Looking at laboratory studies, it was evident that it was the stressed rats that became fatter than the lean rats who could eat at will and at leisure. Many years later, there were studies to show that the stressed rats had put on the fat around the midriff and cortisol may have played a role.

Indians are generally happy people, they are the least of the miserable people of the Americas, but suffering has been their lot ever since that Genovese arrived on these shores. Neglected, subjected to rules and regulations and oppressed with different religious values, this “fatal contact” gave them a generational legacy of suffering: unresolved grief.

You can put it all together and come to your own conclusion. For those of you who would like scientific proof, here is an abstract to follow:

Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2009-0370

The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 8 2692-2701
Copyright © 2009 by The Endocrine Society


The Pathogenetic Role of Cortisol in the Metabolic Syndrome: A Hypothesis

Evidence Synthesis: Emerging data suggest that patients with MetS show hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, which leads to a state of "functional hypercortisolism."The cause for this activation of the HPA axis remains uncertain but may be partly associated with chronic stress and/or low birth weight, which are both associated with increased circulatingcortisol levels and greater responsiveness of the HPA axis. Increased exposure to cortisol contributes to increased fat accumulation in visceral depots. However, cortisol metabolism is not only centrally regulated. The action of 11β-hydroxysteroid dehydrogenase-1 at the tissue level also modulates cortisol metabolism. Increased 11β-hydroxysteroid dehydrogenase-1 activity in adipose tissue and liver might contribute to the development of several features of the MetS.

Conclusions: MetS shares many characteristics of CS, and cortisol might play a role in the development of MetS at both a central and a peripheral level.

MetS Metabolic Syndrome CS Cushings Syndrome/Hypercorticolism

Add to that Native Indians like most indigenous people around the world ( e.g: Australian Aboriginal People; San of Kalahari ) are hyperinsulinemic in that they have an exaggerated insulin response to meals, especially meals which have a different composition from their traditional foods.

Grieving Indians, deprived of their food culture and thus their hunting and gathering culture which made a dramatic impact on their nutrition, going from a highly balanced nutrition to one of contrived nutrition which continues to this day, were sitting ducks for the obesity epidemic to arrive.. even without much trying! Soon Type 2 Diabetes and its consequences followed.

I wish I could lament with a voice stronger than Porfirio Diaz: Pobre Mexico.. tan circa de Estados Unidos y tan lejos de Dios!

Pobre, Pobre Indios !