Dear Doctor: I am a firefighter and in fairly good bodily form, despite the fact that I’ve Type 1 diabetes — however my physique does not present it. Specifically, I’ve flabby abs and man boobs. I stroll, run, do push-ups and crunches, and I feel I eat fairly nicely. What else can I do?
Dear Reader: First, I’ve some questions for you: How lengthy has this been happening? Is the fats across the stomach one thing new or one thing gradual over a few years? Is the gynecomastia (“man boobs”) one thing you could have been coping with since adolescence, or is it one thing you might have solely observed just lately?
Let us start with gynecomastia. Gynecomastia happens in adolescence due to a relative imbalance of estrogen and testosterone. The comparatively elevated ranges of estrogen in contrast to testosterone stimulate breast tissue in adolescent boys, main to breast enlargement. The majority of adolescent boys will lose this breast tissue, however in 20 % the enlarged breast tissue will persist into maturity. In grownup males, some estrogen is produced immediately by the testes, however most is produced from the breakdown of testosterone and the adrenal hormone androstenedione. As in adolescent boys, grownup males can develop gynecomastia if there’s an imbalance between estrogen and testosterone ranges.
Then, in fact, there’s weight problems, which leads to elevated fats in breast tissue. This may give the looks of elevated breast tissue, which is termed pseudo-gynecomastia. Because the fats in the breast tissue carries the enzyme that converts testosterone and androstenedione to estrogen, breast fats may very well improve estrogen ranges and stimulate the formation of breast glands.
Because breast fats and the fats in your stomach are associated, the elemental query is probably going: Why are you storing fats?
First, blame the diabetes — and the connection between the illness and your weight-reduction plan. As a Type 1 diabetic, you’ve got in all probability been on insulin for a few years. Insulin inhibits the breakdown of fats, but in addition stimulates the creation of fats. The larger your physique’s insulin degree, the extra your physique will retailer fats. The extra insulin you inject, the extra fats you’ll retailer.
The greater your calorie consumption and the upper your carbohydrate consumption, the extra insulin you’ll require to hold your blood sugar low. This will lead to a higher storage of fats. Look for meals which might be low in glycemic index, which means low in the meals’s means to increase the blood sugar. Avoid high-sugar meals similar to cookies, candies, desserts, sodas, ice cream and juices. These meals might not be a part of your food regimen. But in the event that they nonetheless are, and in case your honest want is to take away the fats out of your physique, then eliminating these meals will assist. I might additionally advocate limiting the quantity of high-glycemic carbohydrates, reminiscent of bread, pasta, rice, corn and potatoes. Increasing fiber in your food regimen will even lower your insulin necessities.
Then there’s cardio train. Walking, operating, biking, rollerblading, mountaineering, swimming, utilizing an elliptical machine — all of those will allow you to lose and keep a decrease weight.
Of course, even with a great weight-reduction plan and train, you’ll have problem completely dropping this undesirable fats. The necessary level is to be affected person, diligent and extra obsessive about your food plan. This will lower your insulin necessities, assist management your diabetes and allow you to lose the fats.