Minnesota Sleep Society
4th Annual Meeting
Jeffrey Kotulski, D.O.
Carbohydrates
Insomnia
Obesity
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
• Cortisol
• Cortisol
DHEA
5 HTP
Melatonin
Insomnia
Depression
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 antiinflammatory 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 expression
2. Epigenetics
3. Social environment, cortisol
4. Exercise environment
5. 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 Changes
Sleep &
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.
Genetics
The 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 Lane
Mankato, MN 56001
(507) 388-7488