Insulin Resistance Quotes

The healthy snack is one of the greatest weight-loss deceptions. The myth that ‘grazing is healthy’ has attained legendary status. If we were meant to ‘graze,’ we would be cows. Grazing is the direct opposite of virtually all food traditions. Even as recently as the 1960s, most people still ate just three meals per day. Constant stimulation of insulin eventually leads to insulin resistance. (For

The root cause of the hyperglycemia in type 2 diabetes is high insulin resistance.

Carbohydrates trigger insulin release from the pancreas, causing growth of visceral fat; visceral fat causes insulin resistance and inflammation. High blood sugars, triglycerides, and fatty acids damage the pancreas. After years of overwork, the pancreas succumbs to the thrashing it has taken from glucotoxicity, lipotoxicity, and inflammation, essentially “burning out,” leaving a deficiency of insulin and an increase in blood glucose—diabetes.

All the conditions we thought were problems—obesity, insulin resistance, and beta cell dysfunction—are actually the body’s solutions to a single root cause—too much sugar.

failure of insulin to lower blood glucose is called insulin resistance.

Insulin resistance is an important concept, but it is very less talked about or ignored. Insulin resistance is the starting point for all chronic diseases in our body.

Values of TG/HDL-C over 3.5 indicate that you probably have pattern B with a predominance of small LDL particles, and a ratio this high indicates there’s a good chance you may also have insulin resistance[55].

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.

In short, barberries, which can be found inexpensively priced at Middle Eastern groceries in dried form, have been shown to successfully lower LDL cholesterol levels an average of fourteen points (mg/dL),175 as well as improve acne,176 artery function,177 triglycerides, blood sugars, and insulin resistance.

The evidence suggests that nicotine induces weight loss by working on fat cells to increase their insulin resistance, while also decreasing the lipoprotein-lipase activity on these cells, both of which serve to inhibit the accumulation of fat and promote its mobilization over storage, as we discussed earlier

Insulin creates insulin resistance. But insulin resistance also causes high insulin – a classic vicious, or self-reinforcing, cycle. Insulin drives up insulin resistance. This, in turn drives up insulin levels. The cycle keeps going around and around, one element reinforcing the other, until insulin is driven up to extremes.

Excess blue light also causes inflammation and mitochondrial dysfunction, primarily because of its impact on glucose control. In the evening, exposure to blue light causes a peak in glucose levels, leading to higher blood sugar and an increase in insulin resistance.2 This means your blood sugar is higher than it should be, and your

DO YOU HAVE OR HAVE YOU EXPERIENCED IN THE PAST SIX MONTHS . . . — PART A — ■ A feeling you’re constantly racing from one task to the next? ■ Feeling wired yet tired? ■ A struggle calming down before bedtime, or a second wind that keeps you up late? ■ Difficulty falling asleep or disrupted sleep? ■ A feeling of anxiety or nervousness—can’t stop worrying about things beyond your control? ■ A quickness to feel anger or rage—frequent screaming or yelling? ■ Memory lapses or feeling distracted, especially under duress? ■ Sugar cravings (you need “a little something” after each meal, usually of the chocolate variety)? ■ Increased abdominal circumference, greater than 35 inches (the dreaded abdominal fat, or muffin top—not bloating)? ■ Skin conditions such as eczema or thin skin (sometimes physiologically and psychologically)? ■ Bone loss (perhaps your doctor uses scarier terms, such as osteopenia or osteoporosis)? ■ High blood pressure or rapid heartbeat unrelated to those cute red shoes in the store window? ■ High blood sugar (maybe your clinician has mentioned the words prediabetes or even diabetes or insulin resistance)? Shakiness between meals, also known as blood sugar instability? ■ Indigestion, ulcers, or GERD (gastroesophageal reflux disease)? ■ More difficulty recovering from physical injury than in the past? ■ Unexplained pink to purple stretch marks on your belly or back? ■ Irregular menstrual cycles? ■ Decreased fertility?

type 2 diabetes doubles or triples your risk of developing Alzheimer’s disease, about the same as having one copy of the APOE e4 gene. On a purely mechanistic level, chronically elevated blood glucose, as seen in type 2 diabetes and prediabetes/insulin resistance, can directly damage the vasculature of the brain. But insulin resistance alone is enough to elevate one’s risk.

As more calories flood into your subcutaneous fat tissue, it eventually reaches capacity and the surplus begins spilling over into other areas of your body: into your blood, as excess triglycerides; into your liver, contributing to NAFLD; into your muscle tissue, contributing directly to insulin resistance in the muscle (as we’ll see); and even around your heart and your pancreas (figure 4).

Cortisol works more systemically than adrenaline does. It triggers the liver to make more glucose available in the bloodstream while it also blocks insulin receptors in nonessential organs and tissues so that you get all the glucose (fuel) that you need to deal with the threat. Cortisol’s work is a long-term strategy of insulin resistance, which serves to provide the brain with a sustained level of glucose. However, you don’t always have a lot of glucose floating around, so cortisol works to stockpile energy. It converts protein into glycogen and begins to store fat. If the stress is chronic, the increased body fat is stored in the abdomen. If you have a growing bulge in your midsection, it may be due to cortisol working to store energy. Unfortunately, that’s not the way you want it to be stored. It’s better to burn off such stored energy by exercise.

High blood triglycerides interfere with the function of the hormone leptin, causing you to want to overeat rather than rely on your stored body fat for energy. Possibly one-third of the population is fructose intolerant to some degree, evidenced by digestive symptoms such as flatulence, cramps, bloating, irritable bowel syndrome, and diarrhea. Excessive fructose consumption is also linked to fatigue, insulin resistance, diabetes, and high blood pressure.

nonalcoholic fatty liver disease has become the most common chronic liver disease in the world, increasing from 25 percent of the global population in 1990 to close to 40 percent by 2019. NAFLD is full-blown metabolic dysfunction in kids and adults, representing liver cells filling with fat, which worsens insulin resistance. Key contributors are processed foods, refined sugars, refined grains, sweet beverages, high-fructose corn syrup, fast food, low fiber and phytochemical intake, habitual eating close to bedtime, sedentary behavior, and oxidative stress. Liver transplants have gone up close to 50 percent in the past fifteen years, and while alcohol and hepatitis C used to be the leading causes, now NAFLD is taking the lead in women as the cause of liver failure and is a top cause for men. Fatty liver disease is now the most common cause of liver transplant in young adults in the United States. We are failing our children.

Unfortunately, it turns out that the use of glucose during influenza infections significantly increases viral load and illness parameters. Insulin, on the other hand, reduces them considerably and also has the added benefit of lowering HMGB1 levels.

Many things can impair ovulation and promote excess androgens. They include: Thyroid disease, because hypothyroidism impedes ovulation and worsens insulin resistance. [212] Vitamin D deficiency, because your ovaries need vitamin D. Zinc deficiency, because your ovaries need zinc. Iodine deficiency, because your ovaries need iodine. Elevated prolactin, because it increases DHEA. Too little food or too few carbs, because you need carbs to ovulate. If you’re undereating, then you’ve slipped into HA.

Insulin’s effects on calorie storage are so potent that we can consider it the ultimate fat cell fertilizer. For example, rats given insulin infusions developed low blood glucose (hypoglycemia), ate more, and gained weight. Even when their food was restricted to that of the control animals, they still became fatter.9 Conversely, mice genetically engineered to produce less insulin had healthier fat cells, burned off more calories, and resisted weight gain, even when given a diet that makes normal mice fat.10

There’s no getting around the fact that alcohol is very damaging to your system. The majority of alcohol consumed is metabolized by the liver. The rest of your body’s functions can become greatly impaired while the majority of your energy is focused on helping the liver process the alcohol. This in turn causes free radicals, free fatty acids, and LDL (bad cholesterol) numbers to soar. Insulin resistance, liver inflammation, and accelerated aging are some of the many side effects that occur with consistent abuse.

Regular fasting, by routinely lowering insulin levels, has been shown to significantly improve insulin sensitivity. This finding is the missing piece in the weight-loss puzzle. Most diets restrict the intake of foods that cause increased insulin secretion, but don’t address insulin resistance. You lose weight initially, but insulin resistance keeps your insulin levels and body set weight high. By fasting, you can efficiently reduce your body’s insulin resistance, since it requires both persistent and high levels.

Suggesting the standard high-carbohydrate diet purely to keep women out of ketosis results in hyperglycemia and the need for medication, usually insulin, which often results in excess weight gain. With weight gain comes a worsening of peripheral insulin resistance, which results in higher blood sugar and the need for ever increasing doses of insulin and medication. It’s a vicious cycle. Plus, the majority of macrosomic babies are born to mothers with excessive weight gain and prepregnancy obesity, not gestational diabetes.[148]

Prediabetes is easily identified through clinical measurements such as insulin resistance, fasting glucose levels, and glycated hemoglobin (HbA1c, often abbreviated to A1c). Unfortunately, we act on these measurements far less frequently than we should. Early interventions are far easier and far more effective than the more complex and generally ineffective therapies available to treat advanced diabetes. In most cases, all it takes to reverse prediabetes are some straightforward lifestyle choices, including a decrease in dietary sugar and an increase in exercise. These changes require some discipline but are generally simple and even pleasurable.

Triglyceride-to-HDL Ratio After assessing each of these five biomarkers, there is one more step: calculate your triglyceride-to-HDL ratio to better understand insulin sensitivity. Simply divide your triglycerides by your HDL. Interestingly, studies have shown that this value correlates well with underlying insulin resistance. So even if you are unable to access a fasting insulin test, the triglyceride-to-HDL ratio can give you a general sense of where you’re at. According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold—or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.” Dr. Robert Lustig agrees: “The triglyceride-to-HDL ratio is the best biomarker of cardiovascular disease and the best surrogate marker of insulin resistance and metabolic syndrome.” In children, higher triglyceride-to-HDL is significantly correlated with mean insulin, waist circumferences, and insulin resistance. In adults, the ratio has shown a positive association with insulin resistance across normal weight and overweight people and significantly tracks with insulin levels, insulin sensitivity, and prediabetes. Perplexingly, the triglyceride-to-HDL ratio is not a metric used in standard clinical practice. If you remember one thing from this chapter, remember this: you need to know your insulin sensitivity. It can give you lifesaving clues about early dysfunction and Bad Energy brewing in your body, and is best assessed by a fasting insulin test, discussed below. Right now, this is not a standard test offered to you at your annual physical. I implore you to find a way to get a fasting insulin test or to calculate your triglyceride-to-HDL ratio every year. Do this for your children, as well. And take the steps outlined in the following chapters to ensure it does not start creeping up. RANGES: Range considered “normal” by standard criteria: none specified in standard criteria Optimal range: Anything above a ratio of 3 is strongly suggestive of insulin resistance. You want to shoot for less than 1.5, although lower is better. I recommend aiming for less than 1.

As devasting as it is, cirrhosis is not the only end point I’m worried about here. I care about NAFLD and NASH — and you should too — because they represent the tip of the iceberg of a global epidemic of metabolic disorders, ranging from insulin resistance to type 2 diabetes. Type 2 diabetes is technically a distinct disease, defined very clearly by glucose metrics, but I view it as simply the last stop on a railway line passing through several other stations, including hyperinsulinemia, prediabetes, and NAFLD/NASH. If you find yourself anywhere on this train line, even in the early stages of NAFLD, you are likely also en route to one or more of the three Horsemen diseases (cardiovascular disease, cancer, and Alzheimer’s disease). As we will see in the next few chapters, metabolic dysfunction vastly increases your risks for all of these.

In the past few decades we’ve learned to recognise the many hazards of poor nutrition: insulin resistance, obesity, susceptibility to inflammation and fatigue. All of these factors can contribute to an early death. We’ve altered our diets and learned to resist the siren call of sugar and other simple carbohydrates. We’ve now reached a similar point with the news; we think about it today much as we thought about sugar and fast food twenty years ago. News is to the mind what sugar is to the body: appetising, easily digestible and extremely damaging. The media is feeding us titbits that taste palatable but do nothing to satisfy our hunger for knowledge. Unlike books and well-researched long-form articles, the news cannot satiate us. We can gobble down as many articles as we like, but we will never be doing more than gorging on sweets. As with sugar, alcohol, fast food and smoking, the side effects only become apparent later.

To make matters worse, as you get older, your cells gradually become less sensitive to insulin's effects, so insulin levels must rise even more to produce the same results. This leads to a state of insulin resistance, which leads to even more insulin production. Over time, these increasing insulin levels, especially when combined with a poor diet, promote the weight gain and increase in body fat so typical of the aging process. It's not a pretty picture, but this deterioration is far from inevitable. Commonsense lifestyle changes can help you keep your insulin levels under control: Following the major themes of our TRANSCEND program will help you keep your insulin at low, youthful levels. Maintaining a regular vigorous exercise routine burns blood sugar and drives it into your muscle cells, decreasing your body's need for insulin. Following our recommendations for a low-sugar, low-glycemic-load diet will lower insulin levels further. Finally, controlling your stress will lower your cortisol level and avoid the vicious cycle of cortisol-raising insulin.

The resistant starch found in beans powerfully reduces hunger and, thus, food consumption over many hours, coinciding with the fermentation that takes place in the large intestine hours after eating the beans. So eating beans with lunch will reduce your hunger and appetite for dinner many hours later, overall lowering the amount of calories you desire for the day. For diabetics, beans are critical for lowering the insulin requirement for starch digestion. They also supply amino acids that complement the other vegetables, nuts, and seeds to enhance the biologic value of the protein in the diet, without raising IGF-1.

REPROGRAMMING MY BIOCHEMISTRY A common attitude is that taking substances other than food, such as supplements and medications, should be a last resort, something one takes only to address overt problems. Terry and I believe strongly that this is a bad strategy, particularly as one approaches middle age and beyond. Our philosophy is to embrace the unique opportunity we have at this time and place to expand our longevity and human potential. In keeping with this health philosophy, I am very active in reprogramming my biochemistry. Overall, I am quite satisfied with the dozens of blood levels I routinely test. My biochemical profile has steadily improved during the years that I have done this. For boosting antioxidant levels and for general health, I take a comprehensive vitamin-and-mineral combination, alpha lipoic acid, coenzyme Q10, grapeseed extract, resveratrol, bilberry extract, lycopene, silymarin (milk thistle), conjugated linoleic acid, lecithin, evening primrose oil (omega-6 essential fatty acids), n-acetyl-cysteine, ginger, garlic, l-carnitine, pyridoxal-5-phosphate, and echinacea. I also take Chinese herbs prescribed by Dr. Glenn Rothfeld. For reducing insulin resistance and overcoming my type 2 diabetes, I take chromium, metformin (a powerful anti-aging medication that decreases insulin resistance and which we recommend everyone over 50 consider taking), and gymnema sylvestra. To improve LDL and HDL cholesterol levels, I take policosanol, gugulipid, plant sterols, niacin, oat bran, grapefruit powder, psyllium, lecithin, and Lipitor. To improve blood vessel health, I take arginine, trimethylglycine, and choline. To decrease blood viscosity, I take a daily baby aspirin and lumbrokinase, a natural anti-fibrinolytic agent. Although my CRP (the screening test for inflammation in the body) is very low, I reduce inflammation by taking EPA/DHA (omega-3 essential fatty acids) and curcumin. I have dramatically reduced my homocysteine level by taking folic acid, B6, and trimethylglycine (TMG), and intrinsic factor to improve methylation. I have a B12 shot once a week and take a daily B12 sublingual. Several of my intravenous therapies improve my body’s detoxification: weekly EDTA (for chelating heavy metals, a major source of aging) and monthly DMPS (to chelate mercury). I also take n-acetyl-l-carnitine orally. I take weekly intravenous vitamins and alpha lipoic acid to boost antioxidants. I do a weekly glutathione IV to boost liver health. Perhaps the most important intravenous therapy I do is a weekly phosphatidylcholine (PtC) IV, which rejuvenates all of the body’s tissues by restoring youthful cell membranes. I also take PtC orally each day, and I supplement my hormone levels with DHEA and testosterone. I take I-3-C (indole-3-carbinol), chrysin, nettle, ginger, and herbs to reduce conversion of testosterone into estrogen. I take a saw palmetto complex for prostate health. For stress management, I take l-theonine (the calming substance in green tea), beta sitosterol, phosphatidylserine, and green tea supplements, in addition to drinking 8 to 10 cups of green tea itself. At bedtime, to aid with sleep, I take GABA (a gentle, calming neuro-transmitter) and sublingual melatonin. For brain health, I take acetyl-l-carnitine, vinpocetine, phosphatidylserine, ginkgo biloba, glycerylphosphorylcholine, nextrutine, and quercetin. For eye health, I take lutein and bilberry extract. For skin health, I use an antioxidant skin cream on my face, neck, and hands each day. For digestive health, I take betaine HCL, pepsin, gentian root, peppermint, acidophilus bifodobacter, fructooligosaccharides, fish proteins, l-glutamine, and n-acetyl-d-glucosamine. To inhibit the creation of advanced glycosylated end products (AGEs), a key aging process, I take n-acetyl-carnitine, carnosine, alpha lipoic acid, and quercetin. MAINTAINING A POSITIVE “HEALTH SLOPE” Most important,

The type of wheat that we currently consume is called dwarf wheat, named for its short stature relative to other varietals of wheat. Despite its diminutive size, dwarf wheat is highly prolific and produces a lot more grains per acre, which is an outstanding trait for productivity and profitability. 28 However, its nutritional content has declined over the years—ancient grains such as einkorn wheat are 200 to 400 percent higher in vitamin A, vitamin E, and the antioxidant lutein as well as certain minerals when compared to modern wheat. 29 Dwarf wheat is also significantly higher in starch content, especially in a type of starch called amylopectin A that contributes to a higher glycemic index for wheat and has been associated with insulin resistance. 30

colonize the gut may determine our interactions with the environment, protecting us from or predisposing us to the development of allergy and autoimmunity. They may protect us from or predispose us to becoming obese or diabetic. They may inhibit or intensify inflammation in the body. They may interact with artificial sweeteners to cause insulin resistance and weight gain in some individuals. They may even influence mental function and emotional wellness. I first heard about this new view of the microbiome from one

The study found that a ketogenic diet can lead to insulin resistance, fatty liver, a pro-inflammatory state, type 2 diabetes, heart disease, and unhealthy fat regulation, as well as elevated levels of cholesterol, triglycerides, and leptin.

Insulin (mg/dL) Category 50 or above High alert 25 to 49 High, trending towards insulin resistance 17 to 25 Acceptable Target Range: 5 to 17 mg/dL, with

The high glucose stimulates insulin and promotes growth at the expense of a decreased life span. In humans, high insulin levels and insulin resistance, which are common in aging, have been consistently linked to increased risk of many age-related diseases, including cancer and heart disease.

Normally, when sugar enters the bloodstream from our gut, the pancreas secretes insulin into the bloodstream, and the insulin then travels to three main places: fat cells, muscle cells, and neurons. Insulin’s primary job is to open the door to any cell to allow glucose to enter and provide fuel, particularly to three important types of cells. 1. IN FAT CELLS, insulin attaches to a docking port on a fat cell membrane and flips a switch that tells the fat cell to convert that glucose to fat and store it. When insulin has done its job, it separates from the docking port and no more sugar can enter the cell. 2. IN MUSCLE CELLS, insulin unlocks the door to the cell and ushers in glucose to be used as fuel. 3. NERVE CELLS (neurons) also require insulin to admit glucose through their cell membrane. The fact that neurons require insulin to get glucose is a relatively new finding, and we now know that insulin resistance also occurs in the brain and nerves—it is called type 3 diabetes. Once insulin docks in the appropriate ports and releases information, the fat, muscle, or nerve cells tell the hormone that the message has been received. The hormone then backs out of the docking port, leaving it ready and available for the next hormone to attach.

So if insulin is cancer fuel, then we’d be wise to avoid the pathological elevations in insulin levels associated with insulin resistance. And how can we avoid insulin resistance? By avoiding sugar, the primary source of fructose in the modern diet. It is for this reason that, in a recent New York Times Magazine article by Gary Taubes (2011), two of the world’s leading cancer experts confessed to being scared of sugar.

The study compared the effectiveness of daily caloric reduction and intermittent fasting among 107 women. One group reduced their daily caloric intake from 2,000 calories to 1,500 calories. The other group was allowed normal caloric intake (2,000 calories) five days a week but only 25 percent of that (500 calories) on the remaining two days—this is referred to as a 5:2 fast. This means that over the course of a week, average caloric intake for the two groups was very similar: 10,500 calories per week for the reduced-calorie group and 11,000 calories per week for the fasting group. Both groups consumed similar Mediterranean-style diets with 30 percent fat. After six months, both groups had similar levels of weight loss and fat loss. But the 5:2 fasting group showed a clear, substantial improvement in insulin levels and insulin resistance, whereas the caloric-reduction group did not.

trans fat is a form of unsaturated fat not commonly found in nature. Trans fat is created artificially and added to food primarily to increase shelf life, and it’s bad news. Research has associated trans fat intake with a variety of health problems: heart disease, insulin resistance, systemic inflammation, female infertility, diabetes, and more.88 There’s a reason why the Institute of Medicine recommends that our trans fat intake be “as low as possible.” 89 Many

Research has associated trans fat intake with a variety of health problems: heart disease, insulin resistance, systemic inflammation, female infertility, diabetes, and more. •

Nuts, in moderation, are another good choice for an after-dinner indulgence. Most nuts are full of healthful monounsaturated fats, have little or no carbohydrates, and are also high in fiber, which increases their potential benefit. Macadamia nuts, cashews and walnuts can all be enjoyed. Many studies show an association between increased nut consumption and better health, including reducing heart disease8 and diabetes.9 Pistachio nuts, high in the antioxidant gamma-tocopherol and vitamins such as manganese, calcium, magnesium and selenium, are widely eaten in the Mediterranean diet. A recent Spanish study found that adding 100 pistachios to one’s daily diet improved fasting glucose, insulin and insulin resistance.

Dark chocolate also contains significant amounts of fiber and antioxidants such as polyphenols and flavanols. Studies on dark-chocolate consumption indicate that it may help reduce blood pressure,5 insulin resistance6 and heart disease.

But the story gets worse. Insulin resistance, in turn, leads to higher fasting insulin levels. Fasting insulin levels are normally low. Now, instead of starting the day with low insulin after the nightly fast, we are starting with high insulin. The persistence of high insulin levels leads to even more resistance. In other words, insulin resistance itself leads to more resistance—a vicious cycle.

Insulin resistance, in turn, leads to higher fasting insulin levels. Fasting insulin levels are normally low. Now, instead of starting the day with low insulin after the nightly fast, we are starting with high insulin. The persistence of high insulin levels leads to even more resistance. In other words, insulin resistance itself leads to more resistance—a vicious cycle.

The bottom line is that excess fructose is changed into fat in the liver. High levels of fructose will cause fatty liver. Fatty liver is absolutely crucial to the development of insulin resistance in the liver.

If you have more glucose in your body than your cells need, insulin takes extra blood glucose and transports it into fat storage. Blood sugar then returns to normal. This step is important because having abnormally high levels of blood glucose is called diabetes and is very damaging to the body.

Insulin and obesity are still causally linked. However, it is not at all clear that high carbohydrate intake is always the primary cause of high insulin levels. In Kitava, high carbohydrate intake did not lead to elevated insulin. The notion that carbohydrates are the only driver of insulin is incorrect. A critical piece of the puzzle had been neglected. Specifically, sugar plays a crucial role in obesity, but how does it fit in? The missing link was insulin resistance.

What about insulin resistance? At the very beginning of obesity, a person will manifest little insulin resistance, but it develops over time. The longer you are obese, the more insulin resistance you have. Gradually, that insulin resistance will cause even your fasting insulin levels to rise.

High levels of stress can worsen insulin resistance because stress activates our “fight or flight” survival mechanism. This stimulates the production of the stress hormone epinephrine. Epinephrine causes the liver and muscles to change glucose from its reserved state, glycogen, to its active sugar form for energy. This causes the glucose levels in your blood to rise. Insulin rises to control high glucose levels. Increased insulin levels then signal fat storing. This explains why some really stressed people cannot lose unwanted weight despite “doing everything right.

conditions that can set the stage for Hashimoto’s. These include gluten intolerance, estrogen surges, insulin resistance, polycystic ovary syndrome (PCOS), vitamin D deficiency, environmental toxicity, chronic infections and inflammation, and genetic susceptibility to the condition.

The extra fattening effect of sugar is due to the stimulation of insulin resistance from fructose, which festers for years or even decades before it becomes obvious.

SUGAR STIMULATES INSULIN secretion, but it is far more sinister than that. Sugar is particularly fattening because it increases insulin both immediately and over the long term. Sugar is comprised of equal amounts of glucose and fructose, as discussed in chapter 14, and fructose contributes directly to insulin resistance in the liver. Over time, insulin resistance leads to higher insulin levels.

However, moderate consumption of red wine does not raise insulin or impair insulin sensitivity, and therefore may be enjoyed.16 Up to two glasses a day is not associated with major weight gain17 and may improve insulin sensitivity.18 The alcohol itself, even from beer, seems to have minimal effects on insulin secretion or insulin resistance. It is sometimes said that you get fat from the foods you eat with the alcohol rather than from the alcohol itself. There may be some truth to that, although the evidence is sparse.

A 2009 study showed that pre-diabetes could be induced in healthy volunteers in only eight weeks. Healthy subjects ate 25 per cent of their daily calories as Kool-Aid sweetened with either glucose or fructose. While this seems high, many people consume this high proportion of sugar in their diets.17 With its low glycemic index, fructose raised blood glucose much less. The fructose, but not the glucose group, developed pre-diabetes by eight weeks. Insulin levels as well as measures of insulin resistance were significantly higher in the fructose group. So only six days of excess fructose will cause insulin resistance. By eight weeks, pre-diabetes is establishing a beachhead. What happens after decades of high fructose consumption? Fructose overconsumption leads directly to insulin resistance.

AN INSULINOMA IS a rare tumor3, 4 that secretes abnormally large amounts of insulin in the absence of any other significant disease. As the patient’s insulin levels increase, his or her levels of insulin resistance increase in lock step—a protective mechanism and a very good thing. If insulin resistance did not develop, the high insulin levels would rapidly lead to very, very low blood sugars. The resulting severe hypoglycemia would quickly lead to seizures and death. Since the body doesn’t want to die (and neither do we), it protects itself by developing insulin resistance—demonstrating homeostasis. The resistance develops naturally to shield against the unusually large insulin levels. Insulin causes insulin resistance.

In the case of insulin resistance, it comes down to both meal composition and meal timing—the two critical components of insulin resistance.

EXCESSIVELY HIGH INSULIN resistance is the disease known as type 2 diabetes. High insulin resistance leads to elevated blood sugars, which are a symptom of this disease. In practical terms, this means that not only does insulin causes obesity, but also that insulin causes type 2 diabetes.

Cortisol raises blood sugar, while insulin lowers it. Insulin resistance (discussed in depth in chapter 10) is crucial to the development of obesity. Insulin resistance leads directly to higher insulin levels, and increased insulin levels are a major driver of obesity. Multiple studies confirm that increasing cortisol increases insulin resistance.9,10,11

SLEEP DEPRIVATION IS a potent psychological stressor and thus stimulates cortisol. This, in turn, results in both high insulin levels and insulin resistance. A single night of sleep deprivation increases cortisol levels by more than 100 per cent.27 By the next evening, cortisol is still 37 per cent to 45 per cent higher.28

SO WE KNOW that insulin causes insulin resistance. But insulin resistance also causes high insulin—a classic vicious or self-reinforcing, cycle. The higher the insulin levels, the greater the insulin resistance. The greater the resistance, the higher the levels. The cycle keeps going around and around, one element reinforcing the other, until insulin is driven up to extremes. The longer the cycle continues, the worse it becomes—that’s why obesity is so time dependent. People who are stuck in this vicious cycle for decades develop significant insulin resistance. That resistance leads to high insulin levels that are independent of that person’s diet. Even if you were to change your diet, the resistance would still keep your insulin levels high. If your insulin levels stay high, then your body set weight stays high. The thermostat is set high, and your weight will be drawn irresistibly upward. The fat get fatter. The longer you are obese, the harder it is to eradicate.

What happens in the case of insulin resistance? As discussed before, a hormone acts on a cell as a key that fits into a lock. When insulin (the key) no longer fits into the receptor (the lock), the cell is called insulin resistant. Because the fit is poor, the door does not open fully. As a result, less glucose enters. The cell senses that there is too little glucose inside. Instead, glucose is piling up outside the door. Starved for glucose, the cell demands more. To compensate, the body produces extra keys (insulin). The fit is still poor, but more doors are opened, allowing a normal amount of glucose to enter. Suppose that in the normal situation we produce ten keys (insulin). Each key opens a locked door that lets two glucose molecules inside. With ten keys, twenty glucose molecules enter the cell. Under conditions of resistance, the key does not fully open the locked door. Only one glucose molecule is allowed in. With ten keys, only ten glucose molecules are allowed in. To compensate, we now produce a total of twenty keys. Now, twenty glucose molecules are allowed in, but only because we have increased the number of keys. As we develop insulin resistance, our bodies increase our insulin levels to get the same result—glucose in the cell. However, we pay the price in constantly elevated insulin levels.

If you have been overweight or obese for a long time, if you suffer from PCOS (polycystic ovary syndrome), if you are prediabetic, or if you have type 2 diabetes. If this describes you, then it is likely that your body is severely insulin resistant (and if you have been diagnosed as prediabetic or with type 2 diabetes, then this is definitely going to be true for you). The key is going to be getting your insulin down over time so your body can heal. While fasting is wonderful for lowering insulin levels, you may also need a more structured dietary approach to lower insulin even more. Remember that we need to have lower levels of circulating insulin to tap into our fat stores for fuel during the fast. This is where a low-carb or keto plan can make a positive difference. You may not have to follow a lower-carb plan forever; a combination of low-carb eating and intermittent fasting can reverse your insulin resistance over time, and you may find that you can tolerate more carbs as time goes on and your body heals.

also implement weight training, because lifting weights or doing resistance exercises (using resistance bands, weight machines, or your own body weight) is one of the best ways to help with insulin resistance. While aerobic exercise helps your body use insulin better and decreases storage of visceral (abdominal) fat, resistance training makes your body more sensitive to insulin and helps your muscles take up more glucose (sugar) from the blood, thereby lowering blood sugar. Even simply exercising before or right after you eat something with higher carbohydrate levels can help reduce any resulting swings in your blood sugar and insulin release.

Excessive insulin causes obesity, and excessive insulin causes insulin resistance, which is the disease known as type 2 diabetes.

The more of these sugars we consume, and the longer we have them in our diet, the more our bodies apparently adapt by converting them to fat. Our “pattern of fructose metabolism” changes with time, as the British biochemist and fructose expert Peter Mayes says. Not only will this cause us to accumulate fat directly in the liver—a condition known as “fatty liver disease”—but it apparently causes our muscle tissue to become resistant to insulin through a kind of domino effect that is triggered by the liver cells’ resistance.

If there is one single cause of accelerated aging and diseases of aging, it is this: sugar and starch (especially flour) and the resulting metabolic chaos and insulin resistance. You might be tired of hearing this over and over, but eliminating sugar and flour is the single biggest thing you can do to improve your health and extend your life, not only for your hormones and neurotransmitters, but also for every other core system.

The same review of obesity research mentioned earlier also reported a large decrease in fasting insulin levels, which is an indication of improving insulin and glucose metabolism, lowering the risk of insulin resistance, prediabetic and diabetic conditions, high blood sugar levels, and hyperglycemia.

Having type 2 diabetes raises a person’s risk of dying, in some cases to a small degree, in other cases substantially, but it is treatable using drugs, diet, and exercise. Although drugs help, they aren’t always necessary. Diet and exercise can sometimes allow the body to heal itself. In one dramatic test of this concept, ten overweight Australian aborigines with type 2 diabetes reversed their disease after just seven weeks of returning to an active hunting and gathering lifestyle.20 The mechanisms by which physical activity helps prevent and treat type 2 diabetes are well studied. Most basically, exercise (in conjunction with diet) can ameliorate every characteristic of metabolic syndrome including excess organ fat, high blood pressure, and high levels of blood sugar, fat, and cholesterol. In addition, exercise lowers inflammation and counteracts many of the damaging effects of stress. And most remarkably, exercise can reverse insulin resistance by restoring blocked insulin receptors and causing muscle cells to produce more of the transporter molecules that shuttle sugar out of the bloodstream.21 The effect is akin to unclogging a drain and flushing out the pipes. Altogether, by simultaneously improving the delivery, transport, and use of blood sugar, exercise can resuscitate a once resistant muscle cell to suck up as much as fiftyfold more molecules of blood sugar. No drug is so potent.

Soymilk also appears to have the additional benefits of reducing risk of breast3227 and prostate3228 cancers, improving gut health,3229 and decreasing inflammation3230 and free radical DNA damage compared to rice milk or dairy milk.3231 It can also improve insulin resistance3232 and help with stroke rehabilitation, improving walking speed, exercise endurance, grip strength, and muscle functionality,3233 as well as lower blood pressure better than dairy milk.3234 Soymilk can even lower your LDL cholesterol as much as 25 percent after just twenty-one days.3235 Nutritionally, soymilk is considered the best choice for replacing dairy milk in the human diet.

what we now call type 2 diabetes is not a disease of insulin deficiency (as type 1 is)—at least not at first—but of insulin resistance.

Studies have shown that just one night of sleep deprivation can make you as insulin resistant as a person with type 2 diabetes. This translates directly to aging faster, decreased libido, and storing more body fat than you want to (say it ain’t so!).

Another, more subtle problem occurs with chronic stress as well. When something stressful happens, you don’t just block insulin secretion. Basically, the brain doesn’t quite trust the pancreas not to keep secreting a little insulin, so a second step occurs. As noted earlier, during stress, glucocorticoids act on fat cells throughout the body to make them less sensitive to insulin, just in case there’s some still floating around. Fat cells then release some newly discovered hormones that get other tissues, like muscle and liver, to stop responding to insulin as well. Stress promotes insulin resistance.

Make a list of some of the things that can go wrong from the last two chapters: elevated insulin levels in the blood. Elevated glucose levels. Elevated systolic and diastolic blood pressure. Insulin resistance. Too much LDL-cholesterol. Too little HDL. Too much fat or cholesterol in the blood. Suffer from a subset of these, and you’ve got Metabolic syndrome (the formal diagnosis involves “one or more” from a list of some of these problems, and “two or more” from a list of the others).

In adult-onset diabetes (type 2, non-insulin-dependent diabetes), the trouble is not too little insulin, but the failure of the cells to respond to insulin. Another name for the disorder is thus insulin-resistant diabetes.

Migraine, like my patient Sarah had, also correlates closely to poor metabolic health. In the ENT otology clinic, we often saw this condition and had limited success in treating it. Sufferers of this debilitating neurological disease—about 12 percent of people in the United States—tend to have higher insulin levels and insulin resistance. A comprehensive review of fifty-six research articles identified links between migraine and poor metabolic health, pointing out that “migraine sufferers tend to have impaired insulin sensitivity.” The review supports the “neuro-energetic” theory of migraine. Additionally, evidence suggests that micronutrient deficiencies in key mitochondrial cofactors may also be a contributing factor of migraine. Research has suggested that migraines could be treated by restoring levels of vitamins B and D, magnesium, CoQ10, alpha lipoic acid, and L-carnitine. Vitamin B12, for instance, is involved in the electron transport chain responsible for the final steps of ATP generation in the mitochondria, and studies have indicated that high doses of B12 can help prevent migraine. These micronutrients usually have fewer side effects than other drugs used to treat migraines, making them a promising option for relief, which can be obtained through a diet rich in these micronutrients, or supplementation. Having high markers of oxidative stress, a key Bad Energy feature, is associated with a significantly higher risk of migraine in women, with some studies suggesting that migraine attacks are a symptomatic response to increased levels of oxidative stress. Less painful and more common tension-type headaches are also linked to high variability (excess peaks and crashes) in blood sugar. Hearing Loss The same story of metabolic ignorance in the ENT department unfolded for auditory problems and hearing loss, one of the most common issues presented to our ENT clinic. We’d typically tell our patients that their auditory decline was inevitable, due to aging and loud concerts in their youth, and we would suggest interventions like hearing aids. Yet insulin resistance is a little-known link to hearing problems. If you have insulin resistance, you are more likely to lose hearing as you age because of poor energy production in the delicate hearing cells and blockage of the small blood vessels that supply the inner ear. One study showed that insulin resistance is associated with age-related hearing loss, even when controlling for weight and age. The likely mechanism for this is that the auditory system requires high energy utilization for its complex signal processing. In the case of insulin resistance, glucose metabolism is disturbed, leading to decreased energy generation. The impact of Bad Energy on hearing is not subtle: A study showed that the prevalence of high-frequency hearing impairment among subjects with elevated fasting glucose levels was 42 percent compared to 24 percent in those with normal fasting glucose. Moreover, insulin resistance is associated with high-frequency mild hearing impairment in the male population under seventy years of age, even before the onset of diabetes. These papers suggest that assessing early metabolic function and levels of insulin resistance is essential in the ENT clinic and counseling individuals on the potential warning signs is paramount.

Once you have your result, look at the insulin result, not just the glucose result. A healthy “fasting insulin” should be less than 60 pmol/L (10 mIU/L). One and two hours after the glucose drink, a healthy insulin reading should be less than 410 pmol/L (60 mIU/L). High insulin means you have insulin resistance. Normal insulin means you have good insulin sensitivity.

Ultra-processed foods make up 60 percent of calories consumed by adults and 67 percent of calories consumed by children, and they drive Bad Energy diseases like obesity, high blood pressure, dementia, type 2 diabetes, and insulin resistance.

A significant subset of patients with PCOS are overweight or obese and have insulin resistance and hyperinsulinemia.

only 1 percent of children in the United States get the proper RDA levels of the essential nutrients from their diets.1Not only are children not getting proper nutrition for their growing bodies, they are establishing poor eating habits in childhood that usually persist into their adult years. It has amazed me how many of these young teenagers already have full-blown insulin resistance.

Studies have actually shown that there is a very close positive relationship between insulin resistance and hypertension. Actually, diabetics who suffer from hypertension have double the risk of suffering from cardiovascular heart disease.

The concentration of sodium in the blood is controlled to within a very narrow range. When intake rises, the kidneys excrete the excess. When intake falls below 3 to 4 grams a day, the body compensates by activating powerful hormones, called the renin-angiotensin system (RAS), which helps the kidneys hold on tightly to salt.65 The problem is, receptors for RAS are present not only in the kidneys, but also in fat cells, muscle, the pancreas, the lining of the blood vessels, and elsewhere. Overactivity of this system has been shown to cause fat cell dysfunction, insulin resistance, and inflammation—the fundamental problems linking obesity to diabetes and heart disease.

Several studies have documented insulin resistance, higher triglycerides, higher blood pressure, and increased belly fat among research participants given diets with about 150 grams of fructose per day compared to diets with an equivalent amount of glucose.54 However, these studies have been criticized for providing unrealistically large amounts of fructose, triple the average intake of about 50 grams.55 Moreover, high consumption of fruit—the primary natural source of fructose—is associated with better, not worse outcomes in observational studies.56

Fructose Some researchers have found that diets that are high in fructose can impair an individuals' learning abilities and memories over time, this was discovered in a UCLA 2012 study and published in the journal of physiology. In addition to the effects of fructose on the brain, it is also common knowledge (with researchers) that a diet that is high in fructose can cause insulin resistance over time, which may lead to diabetes (type-2) and some extra gain in body fat. Diets that are high in fructose can also affect the blood's triglyceride levels negatively and the small LDL particles in the body that could cause some plaque build-up in the arteries. Hence, high fructose consumption can amount to some impairment of your learning ability and memory, and could also increase your risk of getting diabetes, heart disease and some extra fat. On the average, individuals usually consume a high amount of fructose from processed foods, soft drinks (which is typically made from high-fructose-containing corn syrups), orange juice, juice drinks (sweetened), processed foods like candies and cakes, and the HFCS that may have been added to some store-bought breads, salad dressings and even ketchup.

WHY FAST: Brain function. A neuroscientist Mark Mattson found that intermittent fasting increases levels of a protein called brain-derived neurotrophic factor, or BDNF. This, in turn, stimulates new brain cells in the hippocampus, the region of the brain that is responsible for memory. (Shrinking of the hippocampus has been linked to dementia and Alzheimer’s disease.) Increases mood. The protein called BDNF that helps improve memory also suppresses anxiety and elevates mood. Mattson showed this to be true in a study of rats. He injected BDNF into their brains, and it had the same effect as a regular antidepressant. Increases the effectiveness of insulin, the hormone that affects our ability to process sugar and break down fat. Reduces blood pressure. As your insulin level increases, so does your blood pressure. Insulin stores magnesium, but if your insulin receptors are blunted and your cells grow resistant to insulin, you can’t store magnesium; it ends up passing out of your body through urination. Magnesium in your cells relaxes muscles. If your magnesium level is too low, your blood vessels will constrict rather than relax, which will raise your blood pressure and decrease your energy level. Reduces triglycerides. Insulin upregulates LPL on fat tissue and inhibits activation on muscle cells. On the other hand, glucagon upregulates LPL on muscle and cardiac tissue, while inhibiting the activation of fat. Weight loss. You burn fat, rather than sugar, in a fasted state.

Do we need to eat what our ancestors did or eschew all carbs? I would propose that all we need to do is eat “safe carbs.” That means low sugar to prevent insulin resistance, and high fiber to reduce flux to the liver and prevent insulin hypersecretion. And while we’re at it, eat “safe fat,” that is, real fat rather than synthetic fat (such as trans fats, which can’t be metabolized).

People with major metabolic problems, like severe insulin resistance or type 2 diabetes, may benefit from long-term carbohydrate restriction— to 25 percent of daily calories as in Phase 1 or sometimes even lower. Preliminary studies report that some individuals experience remarkable improvements in health by eliminating virtually all carbohydrates on a ketogenic diet.4

What mostly raises blood sugar—and for most of us this is the only thing that raises blood sugar—is eating starch and sugar. Cut back on them, and your blood sugar will plummet immediately.   

It may not seem fair but your overactive pancreas and resistance to insulin will increase your appetite, weight, and related health issues while wreaking havoc on your life. That is, until you learn to work with it rather than against it. You haven’t gained weight because you’ve eaten too much fat, sugar, or calories. You’ve gained weight because your body releases excess insulin, which opens excess fat cells. Those fat cells are fed at the expense of your normal blood sugar, and that depletes your energy level. Of course, you crave more food as a result! You haven’t caused these problems but you can improve and even correct them. The three steps of the Metabolism Miracle will help you to do it. You may or

Prospective data indicates that the CRP is a better predictor of cardiovascular risk than a low-density lipoprotein (LDL) cholesterol, the standby predictor of cardiovascular disease. The CRP advantage is that “inflammation,” (but not the elevated LDL) is associated with the components of the metabolic syndrome. CRP levels are not only demonstrated with “inflammation” of cardiovascular disease, but also with triglycerides, obesity, elevated blood pressure, and elevated fasting blood glucose. In addition, CRP also correlates with endothelial dysfunction, impaired fibrinolysis, and most importantly, insulin resistance, which is hyperinsulinemia, type 2 diabetes. I ask you, the reader, to please note that the clinical conditions associated with CRP, especially its application for cardiovascular disease, is the pathology of insulin resistance, hyperinsulinemia, type 2 diabetes. Please see Chapter 14, Pathology of Type 2 Diabetes.

Fructose causes insulin resistance and raises insulin levels in the blood

the more insulin resistant one was, the greater the negative impact of a high-carbohydrate diet.

The type of food you consume directly affects your metabolism and insulin response. Food is composed of three macronutrients: protein, carbohydrate, and fat, and each of these macronutrients affects your metabolism in a different way. One gram of protein or carbohydrate provides four calories, while one gram of fat contains nine calories. A calorie is the base unit of heat measurement related to metabolic rate. It measures how much energy a particular food provides to the body. Of course, if you do eat more calories than your body requires, it doesn’t matter whether those calories come from protein, carbohydrates, or fat—the extra fuel will be stored in the body as fat. Eating too few calories can be equally problematic. When you do not eat enough food, your body’s endocrine, immunological, and nervous systems begin to malfunction. The result is often hormonal imbalances, thyroid problems, and insulin resistance. When you are in a state of extreme caloric restriction, your body does everything possible to return to a state of homeostasis, or equilibrium—including slowing down your metabolic rate. A slow metabolism affects your energy levels, your digestive and hormonal health, and your ability to lose weight. In my case, severely restricting my calories increased my adrenal

At a fundamental level, type 2 diabetes begins when fat, muscle, and liver cells become less sensitive to the effects of insulin. This loss of sensitivity, known as insulin resistance, triggers a perilous feedback loop. Normally,

Recognizing that excess visceral fat provokes insulin resistance, which in turn underlies type 2 diabetes, explains why this mismatch disease is almost entirely preventable and why several interrelated factors cause some people to get the disease and others to avoid it. You cannot control two of these factors: your genes and your prenatal environment. But

resistant fiber Resistant fiber is the new kid on the block. It is a unique type of starch that is digested, but only many hours later and only by the good bacteria. Also known as resistant starch, this fiber contains calories, but the majority of its calories are not usable and therefore cannot cause weight gain. Resistant fiber is remarkable since it creates little or no insulin response, unlike any other carbohydrate. In fact, it can even produce less of an insulin response than many non-carbohydrate foods like meat, poultry, and eggs. For this reason, many of the low-carb breakfasts on the Adrenal Reset Diet include foods high in resistant fiber. BEST SOURCES: Boiled potatoes, cannellini beans, navy beans, great northern beans, and unripe bananas.

The obvious implication is that obesity and Type 2 diabetes are two sides of the same physiological coin, two consequences, occasionally concurrent, of the same underlying defects—hyperinsulinemia and insulin resistance.

Sat-Fat Myth #4: Saturated fat promotes insulin resistance and inflammation. True. Some forms of saturated fat (particularly the “long chain” versions) do contribute to insulin resistance and, by extension, inflammation in the body, which does increase your risk for cardiovascular disease and stroke. Palmitic acid (PA) in particular is the type of saturated fat most correlated with insulin resistance and inflammation. But the form of saturated fat that gets all kinds of ugly in your body doesn’t come from eating saturated fat. The harmful kind of saturated fat comes from eating too many refined carbohydrates.

when the liver and muscle glycogen stores are full. In the case of full glycogen stores, the liver then turns the glucose into fat—specifically, a form of saturated fat called palmitic acid (!)—which could be used for energy but is more likely (because you’re a sugar-burner and not fat-adapted) to promote elevated triglycerides, leptin resistance, and insulin resistance and to be added to your fat stores.

Cortisol decreases insulin sensitivity by receptor cells, decreases glucose uptake, and increases blood sugar. The rise in blood sugar is intended to serve as a reservoir for the central nervous system, which requires a continuous supply of glucose to function. Problems arise when this stress state becomes chronic. When cortisol levels (and, therefore, blood sugar levels) are chronically elevated due to the stress in our lives, the risk of insulin resistance and hyperinsulinemia increases, and you start to gain weight. So, by being chronically stressed out, you gain weight.