By Michael Roizen, M.D., And Mehmet Oz, M.D.


Global warming and diabetes; later start times for schools

Q: I hear that global warming is causing more cases of diabetes. Is it because rising global temperatures slow people down so they exercise less? - Rachel M., Gary, Indiana

A: That's certainly a part of the puzzle. (We like your deductive reasoning!) But let us explain how fat metabolizes and how higher temperatures are associated with elevated glucose levels.

Most adipose tissue (that's fat) is either white or brown. (When fat moves from white toward brown, it's referred to as "beige fat.")

Brown adipose tissue is what you use to metabolize and regulate energy. Not enough BAT (it decreases as we age) can allow metabolic disorders, such as obesity and Type 2 diabetes, to develop.

Since BAT generates heat (and metabolizes blood glucose) in response to cold, a team of researchers from the Netherlands made the connection between global warming and increased cases of diabetes. In a study published in BMJ Open Diabetes Research & Care, they concluded that rising global temperatures "negatively impact glucose metabolism via a reduction in brown adipose tissue activity." They surmised that a 1 degree Celsius (1.8 degrees Fahrenheit) rise in temperature would account for over 100,000 new diabetes cases per year in the U.S. alone. That's a huge extra burden on the health care system, not to mention the individual suffering it can cause. (The National Oceanic and Atmospheric Administration reported that 2015 was 0.29 degrees Fahrenheit/0.16 degrees Celsius hotter than 2014.)

So once again, we recommend that anyone with slightly elevated glucose levels (prediabetes) or full-blown Type 2 diabetes, double down on your efforts to prevent or reverse diabetes now. Aim to lose 5 to 10 percent of your body weight, make sure you get 10,000 steps a day, manage stress and stay cool!

Q: Based on information in your column, we started a campaign in the school district for later middle- and high-school start times. But we are getting pushback and need some more ammunition. Can you help? - Elizabeth H., Nyack, New York

A: We agree that too many schools are ringing the school bell alarmingly early - and many organizations and sleep specialists concur. There's even a website for Start Schools Later, Inc. (a nonprofit advocacy group) at www.startschoollater.net/success-stories.html that lists examples of school districts across 44 states (they're not all perfect, but they do address concerns) that have gone to later start times. You'll find great academic and anecdotal data to support smart parents like you.

According to Start Schools Later: "Nearly 10 percent of U.S. high schools start before 7:30 a.m., 40 percent start before 8 a.m., and only around 15 percent start after 8:30. And more than 20 percent of U.S. middle schools start class at 7:45 a.m. or earlier. To accommodate those schedules, bus pickups start shortly after 5:30 a.m. in some districts, and teens must wake at 5 or 6 a.m. to get to school on time."

Parents know the toll this takes on kids. The American Academy of Sleep Medicine agrees. In a newly released position paper, it says unequivocally that middle and high schools should start at 8:30 or later. According to the AASM, it matters because, "during adolescence, internal circadian rhythms [as well as the] biological sleep drive change ... [the] result [is] later sleep and wake times."

Furthermore, they state that adolescents need eight to 10 hours of sleep a night, but almost 70 percent get only seven or less, according to the Centers for Disease Control and Prevention. And multiple studies show that when adolescents get short-changed on sleep they are at risk for:

-Poor school performance

-Obesity

-Metabolic dysfunction

-Increased depressive symptoms

-Suicidal ideation

-Risk-taking behaviors

-More car accidents

-Athletic injuries

So remind the school board or whoever is resisting that if the concern is teaching young minds (and maybe even better teacher performance) and getting great outcomes, later start times definitely improve academic performance, alertness and mental health.

© 2017 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.

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