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.

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.

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.

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.

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.

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.

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.

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.

You need a little bit of fat—even the saturated kind—to maintain normal anabolic hormone levels. When you eat pure carbs and no fat, this can also aggravate blood sugar problems in those who are susceptible, develop into metabolic syndrome, and eventually lead to type 2 diabetes and cardiovascular disease. Eating healthy fat (and fiber) slows digestion, which helps control blood sugar and insulin more effectively. This makes fats especially important for people who are carb intolerant. Most surprising to many, eating nothing but nonfat, high-carb meals can sabotage your fat-loss goals by increasing hunger. After eating carbs without fiber or fat, your blood sugar peaks and quickly crashes, leaving you with that shaky, empty I-have-to-eat-now-or-I’m-going-to-pass-out feeling. It’s more than an emotional craving for a specific food; it’s physical hunger and it’s hard to resist. Cutting out all fat is not the answer. You need to eat fat.

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,

If you could have a gigantic billboard anywhere with anything on it, what would it say and why? My message would be: “Sugar is toxic.” Sugar and other natural or artificial sweeteners are among the most addictive agents in our environment. When consumed in quantities that exceed the rate of metabolism in muscle or the brain, sugar is converted to fat, resulting in insulin resistance, obesity, and an increased risk of many other diseases, including cancers. While consuming fats and proteins evokes a feeling of satiety, consuming sugars induces a desire for more sugar within an hour or so. We evolved this addiction because, in the not-so-distant past, adding fat to our bodies at the end of a growing season when fruits were ripe was essential for surviving until the next growing season. But today, sugar is available all year round and is one of the cheapest foods available. So we continually add fat to our bodies. We may be approaching a time when sugar is responsible for more early deaths in America than cigarette smoking. I have written and lectured extensively on this subject over the past ten years as our understanding of the biochemical basis for the toxicity of sugar, especially the link to cancer, has become more clear.

THREATENING If habitual sugar or the consumption of sugar mimics continues, the metabolic nightmare can turn into a living hell. Similar to those who consume excess alcohol and develop resistance to it, the excess insulin numbs the cells of our muscles. Once this occurs, they no longer vacuum glucose or other essential nutrients from the bloodstream. Unable to gain entry into muscle cells, glucose accumulates in the blood, and cells become old prematurely. Blood gets bad, as seen by sugar levels above 115 (normal

A fasting insulin of greater than 15 microunits/ml usually means significant insulin resistance, and risk for metabolic disease. From the glucose and insulin levels together, you can calculate an index called the homeostatic model assessment of insulin resistance (HOMA-IR = glucose x insulin ÷ 405), which assesses your risk for diabetes. A HOMA-IR of less than 2.8 is excellent, 4.3 is average, and anything higher means trouble.

Changing what you eat, how you move and which supplements you take is the most effective way to reverse insulin resistance and thrive with PCOS.

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.

Glucose and fructose are two kinds of sugars that contain equal amounts of calories (400 calories per 100 grams). Both are unhealthy in large amounts, but fructose even more so than glucose. Glucose can be processed by all organs in the body, whereas fructose is processed mainly in the liver. Consequently, fructose causes an even greater risk of fat accumulation in the liver, resulting in a potbelly, more fats in the blood, and insulin resistance. In addition, fructose creates cross-links with proteins much faster than glucose does. Fructose also sends fewer saturation hormones to the brain than does glucose, making you eat more of it and gain more weight. In short, although all these substances contain equal amounts of calories, they have completely different effects on your metabolism and your health, certainly in the long term.

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.

When we talk about fasting to break insulin resistance and lose weight, we are talking about intermittent fasts of twenty-four to thirty-six hours.

generally with seven hours being the point where weight gain starts. Sleeping five to six hours was associated with a more than 50 percent increased risk of weight gain.26 The more sleep deprivation, the more weight gained. MECHANISMS 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 percent.27 By the

We’ve since discovered, however, that fructose can be formed in the brain from glucose, particularly in states of insulin resistance.85

Indeed, we’re finding that increasing your salt intake, even above what’s generally considered a normal intake, may help improve your insulin sensitivity. One clinical trial found that compared to consumption of about 3,000 milligrams of sodium per day, those who consumed around 6,000 milligrams of sodium per day significantly lowered their glucose response to a 75-gram oral glucose tolerance test. Moreover, the researchers found that when diabetic patients were placed on the higher-sodium diet, their insulin response improved. The authors were quite emphatic and suggested that some people even supplement with sodium, stating that “an abundant sodium intake may improve glucose tolerance and insulin resistance, especially in diabetic, salt-sensitive, or medicated essential hypertensive subjects.”27

Of all the Horsemen, cancer is probably the hardest to prevent. It is probably also the one where bad luck in various forms plays the greatest role, such as in the form of accumulated somatic mutations. The only modifiable risks that really stand out in the data are smoking, insulin resistance, and obesity (all to be avoided)—and maybe pollution (air, water, etc.), but the data here are less clear.

On the other end of the spectrum are high-glycemic carbs, possessing a high dose of sugar, likely refined sugar at that, and little to no fiber. These foods, sometimes labeled “bad” carbs, trigger spikes in blood sugar levels, making it hard for your body’s insulin to metabolize so much quick sugar at once. Over time, this exhausts your pancreas, causing insulin resistance. Insulin resistance inflames your body and its systems, posing a risk factor for metabolic disorders, diabetes, and heart disease. It can also harm estrogen production, the last thing anyone needs. Great examples of high-glycemic carbs aren’t just the obvious ones like packaged treats, sugary cookies, commercial pastries, and candies.

Since BCAAs are mostly found in meat, including chicken and fish, dairy products, and eggs,8034 this may explain why animal protein intake intensifies insulin resistance8035 and is associated with higher diabetes risk,

unhealthy muscle, infiltrated with fat, much like a marbled steak. This can lead to chronic fatigue, loss of strength, and insulin resistance, as well as the limitation of daily activities.

in 2006, we had been researching the effect of fat inside the liver and had discovered that excess fat was potent in preventing insulin from doing its job. The fat itself was making the liver insulin-resistant.

I’m not suggesting that it’s possible to “starve” cancer or that any particular diet will magically make cancer go away; cancer cells always seem to be able to obtain the energy supply they need. What I am saying is that we don’t want to be anywhere on that spectrum of insulin resistance to type 2 diabetes, where our cancer risk is clearly elevated.

Insulin resistance is a term that we hear a lot, but what does it really mean? Technically, it means that cells, initially muscle cells, have stopped listening to insulin’s signals, but another way to visualize it is to imagine the cell as a balloon being blown up with air. Eventually, the balloon expands to the point where it gets more difficult to force more air inside. You have to blow harder and harder. This is where insulin comes in, to help facilitate the process of blowing air into the balloon. The pancreas begins to secrete even more insulin, to try to remove excess glucose from the bloodstream and cram it into cells. For the time being it works, and blood glucose levels remain normal, but eventually you reach a limit where the “balloon” (cells) cannot accept any more “air” (glucose). This is when the trouble shows up on a standard blood test, as fasting blood glucose begins to rise. This means you have high insulin levels and high blood glucose, and your cells are shutting the gates to glucose entry. If things continue in this way, then the pancreas becomes fatigued and less able to mount an insulin response. This is made worse by, you guessed it, the fat now residing in the pancreas itself.

Under proper medical supervision, DHEA may be helpful in the treatment of cancer, diabetes, hypertension, AIDS, herpes, chronic fatigue syndrome, and as replacement therapy for aging. However, caution is advised because there is also evidence that DHEA may lead to insulin resistance and increased coronary risk in women.

The bigger your wheat belly, the poorer your response to insulin, since the deep visceral fat of the wheat belly is associated with poor responsiveness, or “resistance,” to insulin, demanding higher and higher insulin levels, a situation that cultivates diabetes.

Supplements may hinder autophagy. When fasting for metabolic reasons (meaning insulin resistance–related conditions such as type 2 diabetes, obesity, PCOS, and nonalcoholic fatty liver disease), the effectiveness of supplements is questionable. Most vitamins are fat soluble, but if you’re not taking in fat they won’t be as effective. Probiotics are fine to continue taking while fasting.

The up-and-down-day approach is highly recommended: If you have insulin resistance. The down days (particularly if you choose the full-fast option) are great for reducing your insulin levels. If you are dealing with metabolic slowdown. The up days come with a metabolic-boosting benefit that your body may need. If you have plateaued while using an eating-window approach. If you find that your body adapts to the regularity of a daily eating window, the up-and-down-day pattern is great for shaking things up and getting weight loss moving in the right direction.

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.

These measures include ApoB, total particle number, and insulin resistance,

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!).

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.

The brain has a preferred fuel, glucose. Normally, glucose is carried in the blood (where it is often referred to as “blood sugar”), from which it is taken up into muscle, the liver, and the brain as a fuel. For glucose to enter muscle and the liver, the hormone insulin is required, whereas it can enter most regions of the brain even when insulin is absent. The clever way animals respond to food shortage is by making insulin less effective at moving glucose into muscle and the liver. With less glucose going into these tissues, levels in the blood rise, thereby ensuring sufficient glucose for the brain. This phenomenon is called insulin resistance.

When it hibernates, a complete reversal occurs. The animal stops eating and lives off its fat, depending on it to provide the energy and water it needs. It initially stays insulin resistant so that the brain receives sufficient glucose. And when glucose stores eventually run low, leading blood levels to fall, it uses breakdown products from fat called ketones to fuel the brain.

those extra calories can cause a multitude of problems, from NAFLD to insulin resistance to type 2 diabetes,

Again, the #1 risk factor for heart disease isn’t LDL-C; it’s the insulin resistance of metabolic syndrome, of which triglyceride is a much better biomarker than LDL-C. In fact, the largest study of heart attacks in the US revealed that 66 percent of the victims had metabolic syndrome. And the primary driver? Insulin resistance. And its primary driver? Our out-of-control sugar consumption.

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.

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.

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).

begins to digest; this continues for several more hours. Step 3: The level of triglycerides in the bloodstream rises. Step 4: High triglycerides in the bloodstream cause the liver to become resistant to insulin. Step 5: When the liver is not responding well to insulin, it secretes more glucose than usual into the bloodstream. Step 6: The blood glucose rises steadily as the liver’s glucose output goes up.

Fiber is a carbohydrate that is resistant to digestion and does not raise the blood sugar. When looking at the

Dietary fat can also cause another blood sugar rise hours after a meal. This is because fat in the diet can create insulin resistance, which forces the liver to secrete more glucose than usual.

Now here’s where it gets interesting: people who lose the ability to produce insulin can sometimes develop insulin resistance, and those who have insulin resistance sometimes lose the ability to produce insulin.

What causes insulin resistance? Typically, it is a combination of genetics (heredity) and lifestyle (the way we live). Having blood relatives (parents, siblings) with type 2 diabetes greatly increases the risk. Certain ethnic groups, including Native Americans and people of African, Hispanic, Asian, and Pacific Island descent, are also at high risk. The aging process plays a role as well. The older we get, the more insulin resistant we tend to become.

Steroid medications such as prednisone and cortisone also cause insulin resistance. But the most widespread reason people become insulin resistant is weight gain. Too much body fat, particularly around the middle, limits insulin’s ability to function properly. In fact, gaining as little as ten pounds over a fifteen-year period can cause insulin resistance to double.

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.

in making neurotransmitters, the pathways that neurons travel on. The major breakthrough is the fact that the brain becomes insulin resistant. A substance in coconut oil and palm oil called MCT. When the oil is metabolized, it created ketones which could protect the brain from Alzheimer's, it may reverse the disease. It has been tested as possible treatments for Parkinson's Disease, Huntington's Disease, Multiple Sclerosis and amotrophic lateral sclerosis (also known as ALS, or Lou Gherig's disease). There have been some positive results with coconut oil. With further research, there may be a cure for disease that takes so much away from those stricken with the diseases.

chronically elevated insulin levels and all the fun that brings: Increased rates of cancer, accelerated aging, and neurodegenerative diseases such as Parkinson’s and Alzheimer’s, obesity and, ultimately, type 2 diabetes, which is characterized by insulin resistance and chronically elevated blood glucose levels.

If you have followed what I have written thus far and understand how we can become insulin resistant, the solution should be pretty obvious: control carbohydrate levels and other lifestyle factors influencing insulin and leptin sensitivity.

Part of this problem lies with how we do ‘science’. The paradigm of ‘modern science’ is that we isolate each individual factor and study it in isolation. This is the ‘reductionist’ approach to discovering scientific truth. This is straight forward and relatively easy to do, so lots of scientists swear by it. But what if a clinical problem like insulin resistance is not due to a single domino, but rather a number of dysfunctional proteins or other structural materials in combination? The answer – the reductionist approach can’t deliver an answer in this situation. If multiple steps in a pathway, working in varying combinations, eventually compromise that pathway’s action, the reductionist paradigm fails. But if one takes a more holistic or cosmopolitan approach to assessing the problem, the cause of the problem might be better appreciated.

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.

A 2004 article in the Journal of the International Society of Sports Nutrition referred to numerous studies suggesting that a low-carbohydrate intake and the resulting mild ketosis may offer many benefits, including reduction of body fat, minimized damage from insulin resistance and free radicals (caused by metabolizing a high-carbohydrate diet), and a reduction of LDL cholesterol.

Managing the metabolic mayhem in someone with insulin resistance by increasing dietary carbohydrate is like using a flame-thrower to fight a house fire.

SPICE THINGS UP Ground cinnamon has been shown to help prevent insulin resistance, which means it may slow the sugar in frozen yogurt from passing through your stomach too quickly,

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

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

given sufficient time, high-fructose diets can induce high insulin levels, high blood sugar, and insulin resistance, even though in the short term fructose has little effect on either blood sugar or insulin and so a very low glycemic index. It has also been known since the 1960s that fructose elevates blood pressure more than an equivalent amount of glucose does, a phenomenon called fructose-induced hypertension. Because

Though most cells in your body can metabolize glucose quickly, fructose is processed primarily in the liver, where most of it turns to fat. From there, it takes a direct route to your love handles. Though our forebears did okay with the small amount of natural fructose present in fruits, today we’re taking in massively greater amounts. Frankly, our bodies weren’t made to deal with it, as a recent study makes crystal clear.5 Two groups of overweight people were told to eat their usual diet. Individuals in one group had to consume one-quarter of their daily calories as a specially made beverage sweetened with glucose. People in the other group had to consume an otherwise identical beverage sweetened with fructose. There were no other dietary requirements or limitations. As expected, everyone gained weight, but only the fructose-consuming subjects gained fat in the tummy—the most dangerous place to carry extra weight. They also showed increases in insulin resistance plus significantly higher levels of triglycerides. None of these indicators was present in the glucose group. Pass up any product that lists HFCS as an ingredient.

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.

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.

In one study of patients with insulin resistance, researchers found that giving around 6,000 milligrams of sodium per day as compared to 3,000 milligrams of sodium per day ameliorated their insulin resistance.73

There is good evidence that Aborigines are genetically insulin resistant,94 so that some of their metabolic traits ‘are associated with being Aboriginal (mild impairment of glucose tolerance, hyperinsulinemia and elevated total and VLDL [very low density lipoprotein] triglycerides)’.95 In such a population, replacing ancestral food choices with the ‘displacing foods of modern commerce’ must predictably lead to high rates of T2DM.

when something is ever present, you stop responding to it. This insulin resistance contributes not only to type 2 diabetes, fatty liver, and metabolic syndrome, but also to Alzheimer’s disease.

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.

But the primary problem is the excessive insulin, not the insulin resistance. The tissues (heart, nerves, kidney, eyes) are all increasing their resistance to protect themselves from insulin’s toxic delivery. The disease is not insulin resistance. The disease is hyperinsulinemia.

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

Insulin resistance and the diabesity associated with it are often accompanied by increasing belly fat, fatigue after meals, sugar cravings, blood sugar swings or hypoglycemia, high triglycerides, low HDL, high blood pressure, low sex drive, problems with blood clotting, and increased inflammation. These clues can often be picked up long before you ever get diabetes, and may help you prevent diabetes entirely. If you have a family history of obesity (especially around the belly), diabetes, early heart disease, or even dementia or cancer, you are even more prone to this problem.

Within the next decade, one in two Americans will suffer from diabesity—the term now used to describe a range of metabolic imbalances from mild insulin resistance to pre-diabetes to full-blown diabetes. The hardest fact of all to accept is that a breathtaking 90 percent of these people will not be diagnosed. They will carry on and come to learn of their predicament when it’s far too late.

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

Fructose causes insulin resistance and raises insulin levels in the blood