Lipid and Carbohydrate Metabolism:
The Pathogenesis and Management of Chronic Disease
II. Statement
of Purpose:
As the number of people with chronic
diseases such as diabetes and atherosclerosis increases, doctors are faced with
the task of both treating these diseases and preventing them from occurring in
the first place. My project will attempt
to answer the following questions about human metabolism: how can a carbohydrate-low
diet contribute to the management of a chronic disease such as diabetes? What role does diet play in disease
prevention? Working with Dr. John
Walker at Scottsdale Healthcare, I will study the science behind the effects of
diet on maintaining health and treating disease.
III. Background:
In eleventh grade, I took an AP
Biology course, where one of the many topics we discussed was epigenetics, the
study of environmental factors on heritable gene expression, and the effects of
diet on genetics. Earlier this year, we
expanded on this topic in my Capstone Biology course with more of a focus on
diet and chronic disease. This led me to
choose a project dealing with the role of diet in the prevention of chronic
diseases such as diabetes. My father, an
infectious disease physician, often works with Dr. John Walker, who is
researching the effects of a low-carbohydrate diet on diabetes.
IV. Prior
Research:
One group of researchers conducted a
one year trial testing the effects of varying amounts of carbohydrates in the
subjects’ diets on diabetes. It found
that subjects with Type II Diabetes managed their disease with a low glycemic
index. Cholesterol also decreased in
subjects after six months (Gibbs, 2007).
An Annals
of Internal Medicine’s study primarily focused on weight loss rather than
diabetes. While there was no real
difference between groups in terms of weight loss, a low carbohydrate diet
resulted in “diastolic
blood pressure, triglyceride levels, and very-low-density lipoprotein
cholesterol levels, lesser reductions in low-density lipoprotein cholesterol
levels, and more adverse symptoms than did the low-fat diet group” (Wyatt,
2010, p. 1). These effects are linked to
reduced risk and better management of diabetes.
The
Mayo Clinic has been conducting research on lipid metabolism within the Lipid
Core Group through clinical trials.
Studies have included placebo-controlled trials on weight loss drugs,
lowering of cholesterol, and physiological studies based on the lipid lowering by
drugs (2013).
V. Significance:
Curing diabetes is a very relevant
and necessary effort. Diabetes is very
widespread and impactful disease that affects many people. By helping study how diet can affect the treatment
of a disease, we can be one step closer to curing it completely. I hope to learn how a healthy diet benefits
health (separate from obvious physical fitness).
VI. Research
Design & Methods:
I will assist Dr. John Walker in his
clinic in researching the effects of carbohydrate and lipid metabolism in the
acquisition, treatment, and management of diabetes. For the most part, I will learn from him the
specifics and science behind a low-carbohydrate diet in regards to why and how
it affects the human body. After learning the basics, I will help Dr. Walker
crunch numbers in his study of how a low-carb diet affects his patients. In addition, I will go on rounds with Dr.
Walker at the hospital with his medical students in order to get a better idea
of how the altered diet really affects patients with diabetes. I will also likely be put on the diet program
he created so that I can give a first-hand account on the effectiveness and
ease of use of such a program.
VII. Problems:
One of the problems I might
encounter through this project is the availability of information. My advisor will explain the fundamentals of
the process of lipid and carbohydrate metabolism to me, but there is no way of
knowing at this time whether or not I will understand the material, as I have
never really learned this in depth.
Another problem could be the availability of my advisor. Since he is a practicing doctor, he
is busy with his own patients. If I have
a problem with the data collecting, or if I am not sure what exactly to do, Dr.
Walker may not be able to help me, and I will have to solve the problem myself.
VIII. Bibliography:
Division of
Endocrinology, Diabetes, Metabolism, and Nutrition. (n.d.). Lipids.
Foster, G.,
Wyatt, H., Hill, J., & Makris, A., Rosenbaum, D., Brill, C….Klein, S.
(2010, August 3). Weight and Metabolic Outcomes After 2 Years on a
Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial. Annals of Internal
Medicine.
Wolever, T.,
Gibbs, A., Ryan, E., Mehling, C., Chiasson, J., Connelly, P….Ryan, E. (2007,
January 3). The American Journal of Clinical Nutrition. The Canadian Trial
of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of
low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on
glycated hemoglobin but reduction in C-reactive protein.
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