Minnesota Sleep Society 4 th Annual Meeting Jeffrey Kotulski, D.O.
Jan 03, 2016
Minnesota Sleep Society4th Annual Meeting
Jeffrey Kotulski, D.O.
Carbohydrates
ObesityInsomnia
Functional Medicine/Orthomolecular Medicine
Abram Hoffer Linus Pauling
Functional Medicine Matrix
Obesity
• “Diabesity” – Mark Hyman, M.D.
• Obesity: Why are men getting pregnant? Author: Alexander Schauss, Ph. D
• Wheat Belly Author: William Davis, M.D.
Economics
• 1960 - $0.25 of every dollar earned spent on food
• 2010 - $0.08 of every dollar earned spent on food
• 1960 - $0.05 of every dollar earned spent on health care
• 2010 - $0.22 of every dollar earned spent on health care
Insulin Dysregulation -> Inflammation
HPA Axis Issues
• Cortisol DHEA• Cortisol 5 HTP Melatonin Insomnia Depression• Cortisol Muscle Mass (Sarcopenia) Glucose Insulin Resistance
HPA Axis
• Increased cortisol leads to increased consumption of carbohydrates
– This leads to insulin resistance & cortisol resistance
HPA Axis
• Cortisol Resistance– A phenomena of the last decade. The anti-
inflammatory properties are negated, however, the catabolic changes persist.
– Stress = Inflammation
• “Direct inhibitory effects of melatonin upon several ACTH responses in the human adrenal gland.”
Hormone Metabolism Res., 2011, May,
43 (5): 337-42.
What is the Skinny on High Fructose Corn Syrup?
• There is no skinny, it’s all FAT!
Insomnia
• Nocturnal melatonin production is significantly diminished in insomnia patients.
- Psychology Res. 2002, Dec. 12;
113 (1-2): 17 - 27
Where does hyperinsulinemia come from?
1. Genetics – insulin gene expression2. Epigenetics3. Social environment, cortisol4. Exercise environment5. Food environment– High fructose, low fiber
Fructose Is Not Glucose• Fructose is 7 x more likely to form advanced
glycation end-products (AGES)• Acute fructose does not stimulate insulin• Fructose does not suppress grehlin• Chronic fructose exposure promotes
metabolic syndrome• Fructose: “It’s alcohol without the buzz.”
-Gaby, Alterative Medicine Reviews, 2005- Lustig, OrthoMolecular conference, 2013
Fructose
• Of the 600,000 items in the American food supply, 80% have added sugar (sucrose, HFCS).
• Our food environment is “fructosified.”
What About Gluten? (another day)
• Wheat is a very unusual carbohydrate• Amylopectin A – – Spikes blood sugars after consumption more
so than consuming table sugar.
Examples from the Farm
• Cows: THEN lifespan of 10 – 12 years NOW lifespan of 5 years
• Chickens: THEN standing NOW siting
The answer is…. it’s the grains.
What Can We Do?
• Doctors Food Project - Robert Lustig, M.D.
Therapeutic Lifestyle ChangesSleep & Relaxation
Exercise & Movement
Nutrition & Hydration
Stress & Resilience
Relationships & Networks
• Biochemical Individuality
Roger J. Williams, Ph.D.
Fit By Design
• Genetic testing using the following genes:– FABP2– ADRB2– ADRB3– PPARG
• Outcome of genetic analysis allows a personalized plan for long-term health.
GeneticsThe Gene Role of the Gene
FABP2-54 How much dietary fat is absorbed into your bloodstream.
ADRB2-16 Where you store fat.Your most efficient exercise.
ADRB2-27 How fat is used for energy and how high carb diets influence weight gain.
ADRB3-64 How much exercise stimulus you need weekly to maintain or lose weight.
PPARG-7 A nuclear receptor involved with metabolism pathways at the cellular level
Jeffrey Kotulski, D.O.
45 Teton LaneMankato, MN 56001
(507) 388-7488