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