Diabetic Living Australia – May-June 2019

(やまだぃちぅ) #1

Good news! Big gains can
come from a relatively small
weight loss. We spoke to a range
of medical experts about how
losing even just 10 per cent of
your body weight can radically
improve your health and longevity.


WEIGHT AND BLOOD
PRESSURE/HEART
HEALTH
Dr Shruti Kapila, Cardiologist
If you’re genetically at risk of
uncontrolled blood pressure,
weight is even more significant
than previously thought, says
Dr Shruti Kapila from Sydney’s
Burwood Heart Centre.
“Hundreds of studies have
looked at the effect of ‘salt
sensitivity’ on blood pressure,”
she says. “However, only in recent
years has the focus shifted to how
your individual genetic ‘weight
sensitivity’ can also impact
blood pressure.
“So, while one person may
put on 5kg and it has little or
no effect on blood pressure, for
someone whose blood pressure is
weight sensitive, losing just 5kg
may make a big difference.”
So, what’s the link between
blood pressure and heart attacks?
“With normal blood pressure,
arteries are elastic and flexible,
but high blood pressure increases
the risk of heart problems in two
main ways,” says Dr Kapila.
“Firstly, hypertension makes
the heart work harder and the
force of extra blood pumping
around your body can cause
the left ventricle of the heart
to enlarge or stiffen. Over
time a stiff heart fails to pump
effectively and starts to fail.
“Secondly, high blood pressure
can cause cellular changes to
the lining of the arteries, which
allows more fat and plaque to
collect or ‘block’ the arteries. Add


weight or cholesterol on top and
it’s a double or triple whammy.”
She says as a general rule
of thumb, for every 10-point
increase in systolic blood
pressure (top number) there
is a 25 per cent increase in the
chance of heart attack or stroke.
“So in short, yes, weight loss
can truly help keep it down. Some
studies suggest every 1kg in
weight reduction means lowering
of blood pressure by 1 point.”

Geraldine Georgeou, Dietitian
“In patients who are overweight
(but not obese), or for people
who have pre-diabetes, losing
about 10 per cent of body weight
will often see blood sugars return
to normal levels,” says dietitian
Geraldine Georgeou from
diabetesclinics.com.au.
“The old way of thinking about
diabetes was that pancreatic
beta cells were destroyed when
diabetes was diagnosed.
“However, a recent study in
The Lancet Medical Journal shows

that substantial weight loss at
the time of diagnosis of type 2
diabetes may actually ‘rescue’
the pancreatic cells and have
a powerful effect at the onset of
the condition.
“A year after the study
started, almost half of the 300
participants had their blood
[glucose] levels return to normal.”
“For severely obese patients,
bariatric surgical intervention
is generally required,” she says.
“For overweight patients with
insulin resistance or pre-diabetes,
though, the majority of these
people will notice a substantial
improvement in lipid profiles
and glucose control with about
5-10kg of weight loss.”

WEIGHT AND
JOINT MOBILITY
Dr Jonathan Herald, Shoulder,
Elbow and Knee Surgeon
“Every extra 1kg of weight
means up to 4kg of force through
the knee when squatting or
climbing stairs,” says Sydney
shoulder, elbow and knee surgeon
Dr Jonathan Herald.
“Quite often losing 10 per
cent of your body weight will
be enough to make a marked
difference in knee pain and
mobility.
“While surgery is increasingly
the option for severely
overweight people, for people
who are slightly overweight with
niggling knee pain, weight loss
can certainly help.
“And strengthening is
important, too. Some of the best
exercises to strengthen knees in
overweight people include calf
raises, straight leg raises, wall
squats or simply just getting
up and sitting back down in a
chair five times, pushing
through the heels.”

diabetic living MAY/JUNE 2019 97

KNOW YOUR


BP NUMBERS


120/80 = “This is ideal, but normal
is considered <130/85. However,
for some conditions such as diabetes
or kidney disease even going beyond
120/75 is too high for them. Being
vigilant and knowing your targets is
imperative!” says Dr Kapila.
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