This book has been made possible by the contributions of leading scientists and clinicians from upcoming and interdisciplinary fields of research concerning the molecular and clinical features of insulin resistance. Multiple metabolic disturbances associated with Insulin Resistance include inflammatory cytokines, adipokines, endothelial dysfunction, tissue-specific defects in insulin action and signaling, oxidative stress, ectopic lipid deposition, and disordered neuroregulation.
Some proposed calorielowering strategies include eating
foods that are low in calories for a given measure of food
(e.g., many kinds of vegetables and fruits and some soups).
However, when making changes to improve nutrient intake,
one needs to make substitutions to avoid excessive calorie
intake. The healthiest way to reduce calorie intake is to
reduce one’s intake of added sugars, fats, and alcohol,
which all provide calories but few or no essential nutrients
(for more information, see chs.
Excess abdominal fat, assessed by measurement of waist circumference or waist-to-hip ratio, is independently associated with higher risk for diabetes mellitus and cardiovascular disease. Measurement of the waist circumference is a surrogate for visceral adipose tissue and should be performed in the horizontal plane above the iliac crest. Cut points that define higher risk for men and women based on ethnicity have been proposed by the International Diabetes Federation (Table 75-3).