Metabolic Health Quotes

Organic Oreos are not a health food. When Coca-Cola begins selling organic Coke, as it surely will, the company will have struck a blow for the environment perhaps, but not for our health. Most consumers automatically assume that the word "organic" is synomymous with health, but it makes no difference to your insulin metabolism if the high-fructose corn syrup in your soda is organic.

A disruption of the circadian cycle—the metabolic and glandular rhythms that are central to our workaday life—seems to be involved in many, if not most, cases of depression; this is why brutal insomnia so often occurs and is most likely why each day’s pattern of distress exhibits fairly predictable alternating periods of intensity and relief.

The Hedonistic Imperative outlines how genetic engineering and nanotechnology will abolish suffering in all sentient life. This project is ambitious but technically feasible. It is also instrumentally rational and ethically mandatory. The metabolic pathways of pain and malaise evolved only because they once served the fitness of our genes. They will be replaced by a different sort of neural architecture. States of sublime well-being are destined to become the genetically pre-programmed norm of mental health. The world's last aversive experience will be a precisely dateable event.

All of this suggests that one of the best things each of us can do—not only for ourselves, but also for our children and grandchildren—is to metabolize our pain and heal our trauma. When we heal and make more room for growth in our nervous systems, we have a better chance of spreading our emotional health to our descendants, via healthy DNA expression. In contrast, when we don’t address our trauma, we may pass it on to future generations, along with some of our fear, constriction, and dirty pain.

Nothing breaks my heart more than seeing that person who’s struggling to lose weight who thinks that they need to run 20 miles a week. They have no desire to do it, their knees hurt, they hate it, and they’re not losing weight. And I’d like to say, ‘Well, I’ve got great news for you. You don’t ever need to run another step a day in your life, because there’s no value in that.’ “There is value in exercise, though, and I think that the most important type of exercise, especially in terms of bang for your buck, is going to be really high-intensity, heavy strength training. Strength training aids everything from glucose disposal and metabolic health to mitochondrial density and orthopedic stability. That last one might not mean much when you’re a 30-something young buck, but when you’re in your 70s, that’s the difference between a broken hip and a walk in the park.

Yes: we have arrived at our common thread, the underpinning factor that lets us answer our tangled questions about causes and treatments, symptoms and overlaps. Mental disorders—all of them—are metabolic disorders of the brain.

If we added up all of the special ‘avoidance’ diets, no one could eat anything.  Many people are ruining their health by avoiding too many foods.” -Ray Peat

Americans now eat more than one million chickens per hour.

High quality sleep fortifies your immune system, balances your hormones, boosts your metabolism, increases physical energy, and improves the function of your brain.

Do human cells have “drivers” making the cells stop and go? It turns out that they do. The drivers of human cells, and human metabolism, are called mitochondria. And they are the common pathway to mental and metabolic disorders

Eighty percent of American Farm Bill subsidies go to corn, grains, and soy oil. Amazingly, tobacco receives four times more government subsidies (2 percent) than all fruits and vegetables combined (0.45 percent).

Coconut’s distinctive medium-chain composition has been shown to offer protection from heart disease, cancer, diabetes, and many other degenerative illnesses, to improve immune function and fat metabolism, and to protect against liver damage from alcohol and other toxins, and deliver anti-inflammatory and immune-supporting properties.

How many fluids should you take in daily?  That is an unanswerable question with all of the variables that affect our fluid needs at any given time.  If you meet anyone who can answer that question for you, run away quickly.

Factoid: Within the class of nutrients called ‘carbohydrates’, there is no molecule that is essential for human health or well-being. This does not mean that blood sugar is completely unimportant, but rather that blood sugar can be well-maintained via metabolic processes such as gluconeogenesis without dietary carbohydrates in the keto-adapted human.

WHAT’S GOOD FOR THE HEART IS GOOD FOR THE BRAIN. That is, vascular health (meaning low apoB, low inflammation, and low oxidative stress) is crucial to brain health. WHAT’S GOOD FOR THE LIVER (AND PANCREAS) IS GOOD FOR THE BRAIN. Metabolic health is crucial to brain health. TIME IS KEY. We need to think about prevention early, and the more the deck is stacked against you genetically, the harder you need to work and the sooner you need to start. As with cardiovascular disease, we need to play a very long game. OUR MOST POWERFUL TOOL FOR PREVENTING COGNITIVE DECLINE IS EXERCISE. We’ve talked a lot about diet and metabolism, but exercise appears to act in multiple ways (vascular, metabolic) to preserve brain health; we’ll get into more detail in Part III, but exercise—lots of it—is a foundation of our Alzheimer’s-prevention program.

Make sure your diet and lifestyle is something that you love and want to continue for life.  If you feel that way about it, you’ve found the healthiest diet for you.  Make the diet fit your life.  Don’t change your life around to fit your diet.  Don’t let the diet take over your life.  Let it play a supporting role in your life, helping you to feel better and have more energy for the things you would love to do and experience.

Fasting carries significant health benefits. Metabolism increases, energy increases and blood sugars decrease. The only remaining question is this: Can you do it? I hear this one all the time. Absolutely, 100 percent yes. In fact, fasting has been a part of human culture since the dawn of our species.

Between 1909 and 2007, meat intake rose from 124 pounds to more than 200 pounds per person per year. That’s more than seventy-five pounds of extra meat for every person every year.

Weight loss is not a goal, it’s either something that happens or doesn’t happen as a result of living, eating, and moving in smarter and healthier ways.

What I have found over and over is that, once we have made short-term changes, they tend to change our long-term habits.

Health, not illness, is our natural state. It’s usually just a matter of finding it tucked beneath the layers of imbalance that have accumulated over time.

deep sleep for learning and memory, not to mention all branches of bodily health, from cardiovascular and respiratory, to metabolic, energy balance, and immune function.

The real model for health, however, is more complicated. The real model goes like this: eating low-quality foods leads to overeating and metabolic brokenness, which makes you overweight and sick.

Fructose, which is often paired with glucose, is naturally present in fruit and honey, as well as table sugar (sucrose, which is 50 percent fructose). Assuming your baker used plenty of sugar, your cake probably has a fair amount of fructose. Unlike glucose, which can be metabolized (essentially burned) by cells throughout the body, fructose is almost entirely metabolized by the liver. The liver, however, can burn only so much fructose at once, so it converts any excess fructose into fat, which again is either stored in the liver or dumped into the bloodstream. As we will see, both of these fates cause problems.

The most blatant and deadly example of the intervention-based incentives of our medical system is that medical leaders are absolutely silent on the things that are actually making us sick: food and lifestyle.

If you sit all day but get 10,000 steps over the course of one hour by going for a run, that’s less health promoting than if you space out those steps over every hour of the day (more on this in Chapter 8). Wearables

First, when you try to restrict calories and exercise more, your body is hardwired to perceive a starvation situation. That makes you tired (so you move less and conserve energy) and hungry (so you eat more), and it slows down your metabolism (so you don’t die!). This “eat less, exercise more” formula is not too successful for most people. It can work for a short time, certainly, but less than 10 percent of people lose weight and keep it off for a year;4 you will almost always rebound and gain back the weight. Second, when you eat carbs and sugar, insulin spikes and your blood sugar drops. The insulin drives most of the available fuel in your bloodstream into fat cells, especially the fat cells around your middle, otherwise known as belly fat. So your body is starved of fuel, and this stimulates your brain5 to make you eat more.6 You could have a year’s worth of stored energy in your fat tissue and yet feel like you are starving. The only thing that can stop this vicious cycle is eating a lot of fat and cutting out the refined carbs and sugar. A high-fat, low-carb diet leads to a faster metabolism and sustained weight loss.

The day may come when the obese people of the world must give up diets, since metabolizing their fat deposits will lead to DDT poisoning. But, on the bright side, it is clear that fewer and fewer people in the future will be obese!

Bone broth is considered a powerful detoxification agent since it helps the digestive system expel waste and promotes the liver’s ability to remove toxins, helps maintain tissue integrity and improves the body’s use of antioxidants.

Cutting carbs, fats, or calories (dieting) is like trying to hold your breath.  The longer you do it, the more your body resists it until you finally gasp for air – taking in more than ever to overcome the short-term deficit you induced.

Yogasanas have often been thought of as a form of exercise. They are not exercises, but techniques which place the physical body in positions that cultivate awareness, relaxation, concentration and meditation. Part of this process is the development of good physical health by stretching, massaging and stimulating the pranic channels and internal organs. When yogasanas are performed, respiration and metabolic rates slow down, the consumption of oxygen and the body temperature drop. During exercise, however, the breath and metabolism speed up, oxygen consumption rises, and the body gets hot. In addition, asanas are designed to have specific effects on the glands and internal organs, and to alter electrochemical activity in the nervous system.

Recent studies have shown that the composition of the nursing mother’s diet has a major influence on the baby’s risk for metabolic disease and obesity later on in life, and much of this is mediated by the early programming of the baby’s gut microbiota.

Fermented foods contain natural probiotics, or healthy bacteria, that can take your health to the next level. Nearly every culture has a version of a fermented food: yogurt, kefir, miso, and fermented vegetables, including sauerkraut, pickles, and kimchi.

The best advice I can give anyone in transforming their health is to find a way—any way—to stick with totally unprocessed, organic food for just a month or two. By the end of this time, I can guarantee that your preferences and cravings will have changed.

Your waist size is such an important predictor of health because the type of fat that is stored around your waistline—called “visceral fat” or “belly fat”—is related to the release of proteins and hormones that cause inflammation, which can in turn damage your arteries and affect how you metabolize sugars and fats. For this reason, visceral fat is strongly linked to type 2 diabetes, heart disease, stroke, Alzheimer’s, and other chronic diseases. Seeing your waist size come down is a great indicator of improving health.

Barrett said that when we’re dehydrated, we don’t necessarily feel thirsty—we feel exhausted. When we have something odd happening in our stomach, our body doesn’t quite know if we have a menstrual cramp or a stomachache or if we need to poop. We might not even be aware for a long period of time that our stomach hurts. And this isn’t unique to people with PTSD. It’s normal, everyday bodily dissociation that we all suffer from. If we find ourselves in a shitty mood, we might not necessarily be mad about a certain trigger. We could just be running at a metabolic deficit. Our body might be screaming “I NEED FUNYUNS” while we project our hangriness onto, say, this poor sweaty schmuck who’s breathing too loud in the elevator. But Barrett said that PTSD does make these inclinations worse. It affects a variety of systems in the body, throwing them all out of whack. Our hearts might beat faster. Our lungs might pump harder. Our body budget can get tipped off-balance more easily. And when it does, our reactions to these deficits can feel outsized. “Make sure that you get enough sleep, make sure you exercise, make sure that you eat in a healthful way,” she told me when I asked her what I could do to be a better person. When I countered that that didn’t seem like enough, she kindly offered, “You know, all you can do is take as much responsibility as you can. And sometimes it’s the attempt that matters, you know, more than the success.” Then she chuckled at herself. “That’s a very Jewish mother response!” So, first step of hacking my brain: sustaining it with enough oxygen and nutrients

I deeply respect doctors, but I want to be very clear on something: at every hospital in the United States, many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them. Suicide and burnout rates are astronomical in health care, with approximately four hundred doctors per year killing themselves. (That’s equivalent to about four medical school graduating classes just dropping dead every year by their own hand.) Doctors have twice the rate of suicide as the general population. Based on my own experience with depression as a young surgeon, I think a contributor to this phenomenon is an insidious spiritual crisis about the efficacy of our work and a sense of being trapped in a system

Your diet shouldn’t have a name or be something you can tweet about using the # sign.  If you, in your chronic dieting ways must name it, it should be your first name, followed by an apostrophe s, and the word “Diet.”  So for example, what I eat is referred to as “Matt’s Diet.”  If your name is Jean Claude Van Damme, then what you eat is called “Jean Claude’s Diet,” and probably consists mostly of metal chards and King Cobra filets.  If your name is Shooter McGavin, then you probably eat pieces of shit like Happy Gilmore for breakfast.

Metabolically speaking, if sugar has an evil twin, then "drinking alcohol" can become the demon spawn. This is because sugar converted to booze converts to ethanol plus carbon dioxide, and if you imbibe--do not pass Go. Do not collect two hundred dollars. Go straight to the liver.

Bad Energy Foods If you remember one food principle in this book, remember that cutting the unholy trinity of these three ingredients from your diet will completely change your health and ensure you’re making room for more Good Energy foods: Refined added sugar Refined industrial vegetable and seed oils Refined grains

Focusing on individual nutrients, their identities, their contents in food, their tissue concentrations, and their biological mechanisms, is like using math and physics to catch balls. It’s not the way nature evolved, and it makes proper nutrition far more difficult than it needs to be. Our bodies use countless mechanisms, strategically placed throughout our digestion, absorption, and transport and metabolic pathways, to effortlessly ensure tissue concentrations consistent with good health—no database consultation required. But as long as we let reductionism guide our research and our understanding of nutrition, good health will remain unattainable.

Dietary fat was singled out as the most villainous culprit responsible for weight gain and declining health. The food industry adjusted by replacing saturated animal fats with “heart healthy,” super-processed vegetable seed oils, and high fructose corn syrup. Soon, our average body weight started to rise, and it did so quickly.

Social reality is not just about words—it gets under your skin. If you perceive the same baked good as a decadent “cupcake” or a healthful “muffin,” research suggests that your body metabolizes it differently. Likewise, the words and concepts of your culture help to shape your brain wiring and your physical changes during emotion.24

Scientists generally agree that the more HDL you have, the lower your risk for heart disease. As you might have imagined, people with Metabolic Syndrome and type 2 diabetes also typically have low levels of beneficial HDL. Exercise is one of the cheapest, easiest, and most effective ways to raise HDL. Consuming saturated fat is another!

Simple markers can show us “check engine” alerts. A most basic and accessible way to see if you have a reasonable level of metabolic health is by checking five markers that are almost always tested and tracked at your annual checkup: blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference. When these markers fall into an optimal range, in the absence of medication—see Chapter 4 for exact specifications—you can deduce that your cellular energy production is doing OK. Typically, you will feel vibrant, healthy, and pain-free. These feelings, too, should tell you that your body has Good Energy, the foundation of general good health.

These visceral (belly) fat cells behave differently than fat elsewhere in the body in two important ways.25 First, they are several times more sensitive to hormones and thus tend to be more metabolically active, which means they are capable of storing and releasing fat more rapidly than fat cells in other parts of the body. Second, when visceral cells release fatty acids (something fat cells do all the time), they dump the molecules almost straight into the liver, where the fat accumulates and eventually impairs the liver’s ability to regulate the release of glucose into the blood. An excess of belly fat (a paunch) is therefore a much greater risk factor for metabolic disease than a high BMI.

Muscle Contraction Is Medicine The reason that moving regularly is important is because a body in which muscles are contracting frequently (even at low intensities for short periods) is experiencing totally different physiology than a body where the muscles are worked in only a one- to two-hour exercise block per day (no matter how intense that block). Muscle contraction is miraculous medicine.

Sitting here in my lab, I can imagine you scratching your head again: Dr. Panda, what’s the big deal? Aren’t we talking about just a few ounces of fat gain after a late-night snack? Won’t my metabolic rhythm come back the next day? Actually, it’s worse than you think. It is hard enough for the body to monitor hormones, genes, and clocks for someone with a strict eating routine. But when eating occurs at random times throughout the day and night, the fat-making process stays on all the time. At the same time, glucose created from digested carbohydrates floods our blood and the liver becomes inefficient in its ability to absorb glucose. If this continues for a few days, blood glucose continues to rise and reaches the danger zone of prediabetes or diabetes. So, if you’ve wondered why diets haven’t worked for you before, timing might be the reason. Even if you were diligently exercising; counting calories; avoiding fats, carbs, and sweets; and piling on the protein, it’s quite likely that you weren’t respecting your circadian clocks. If you eat late at night or start breakfast at a wildly different time each morning, you are constantly throwing your body out of sync. Don’t worry, the fix is equally simple: Just set an eating routine and stick to it. Timing is everything.

key reason why we are chronically consuming far too much food energy is because of the wide accessibility of ultra-processed, industrially manufactured foods, which impair our body’s self-regulatory satiety mechanisms and directly trigger hunger and cravings. These ultra-processed industrial foods are chemically engineered to be addictive and make up nearly 70 percent of calories that people in the United States consume today.

which their previous doctors have chalked up to “normal.” These symptoms often include neck pain, seasonal sinus infections or recurrent colds, eczema, itchy ear canals, lower-back pain, acne, headaches, bloating, reflux, chronic cough, a little anxiety, trouble falling asleep, low energy, and PMS symptoms like cramps and moodiness. None of this is normal. You can and should feel incredible—mentally and physically—most of the time.

Anyone can prove whatever they want. It's easy. I could "prove," via those mechanisms that carbs are the devil, fat is the devil, protein is the devil, grains destroy your digestive tract, grains are the ultimate food for digestive health, fruit is the devil, fruit is the salvation of mankind, dairy is the perfect food, dairy is atherogenic, dairy causes autoimmune disease, dairy cures autoimmune disease, fat makes you fat, fat makes you thin...

Prioritize whole, unprocessed, nutrient-rich, nourishing foods. Eat vegetables, grass-fed and pastured meats and eggs, wild-caught seafood, and some fruit, nuts, and seeds. Avoid foods that are likely to be more harmful than healthful. Especially when regularly consumed, certain foods can trigger inflammation, cause digestive problems, or derail our natural metabolic processes, such as grains, legumes, sugar, and processed seed and vegetable oils.

Gerontologists studying the aging process find increasing evidence that most of us will age with a fair degree of success. There’s far less institutionalization and disability than one might have guessed. While the size of social networks shrink with age, the quality of the relationships improves. There are types of cognitive skills that improve in old age (these are related to social intelligence and to making good strategic use of facts, rather than merely remembering them easily). The average elderly individual thinks his or her health is above average, and takes pleasure from that. And most important, the average level of happiness increases in old age; fewer negative emotions occur and, when they do, they don’t persist as long. Connected to this, brain-imaging studies show that negative images have less of an impact, and positive images have more of an impact on brain metabolism in older people, as compared to young.

TRUST THE SYSTEM ON ACUTE ISSUES, IGNORE IT ON CHRONIC Most health care books give recommendations and end with a disclaimer to “consult your doctor.” I have a different conclusion: when it comes to preventing and managing chronic disease, you should not trust the medical system. This might sound pessimistic or even frightening, but understanding the incentives of our medical system and why it does not deserve our benefit of the doubt is the first step to becoming an empowered patient.

The pounds of molecular information we put into our bodies daily impact our health. Every thought you have and feeling you feel comes from food. Inside your mother’s body, you were 3D printed out of food, and every item you ingest continues to print the next iteration of yourself. Bodies, neurotransmitters, hormones, nerves, and mitochondria are all made, exclusively and necessarily, from what you (or your mom) put in your (or their) mouth; we don’t arise from thin air, we arise from food.

Six out of ten adults are living with a chronic illness. About 50 percent of Americans will deal with mental illness sometime in life. Seventy-four percent of adults are overweight or have obesity. Rates of cancer, heart disease, kidney disease, upper respiratory infections, and autoimmune conditions are all going up at the exact time we are spending more and more to treat them. In the face of these trends, American life expectancy has been declining for the most sustained period since 1860.

Eating a Paleolithic diet is not about historical re-enactment; it is about mimicking the effect of such a diet on the metabolism with foods available at the supermarket. There was no one diet eaten throughout the entire Paleolithic, nor is there a single diet eaten by contemporary hunter-gatherers. Hunter-gatherer diets can vary substantially depending on the geography, season, and culture. Even so, the commonalities among hunter-gatherer diets provide useful parameters for a healthy modern diet.

There’s a saying that insanity is doing the same thing over and over and expecting different results. And that’s precisely what has happened to national nutritional policy in the United States in recent years. The government ignores studies that don’t fit within a preconceived template of a low-fat, low-salt, calorie-restricted, high-carb, plant-based diet. But this one-size-fits-all approach to eating does not work for the large segment of the population that is dealing with obesity and other metabolic chronic health issues.

When our cells sense sustained danger, they divert resources to defense and alarm pathways instead of normal functions that generate sustainable health. Given this, no matter how pristine your dietary intake is, how much you’re moving, how much sunlight you’re getting, or how many hours of quality sleep you’re getting, if the cells are bathed in a stew of stress created by the way psychology translates to biochemistry (via hormones, neurotransmitters, inflammatory cytokines, and neurologic signals), all the other healthy choices will fall

About 74 percent of U.S. adults are overweight or obese, and 93.2 percent have metabolic dysfunction. These numbers sound high until you realize how many levers of modern society are stacked against our mitochondria and metabolism: too much sugar, too much stress, too much sitting, too much pollution, too many pills, too many pesticides, too many screens, too little sleep, and too little micronutrients. These trends—with trillions of dollars behind them—are causing epidemic levels of mitochondrial dysfunction and underpowered, sick, inflamed bodies.

Many factors other than your size, fat, and muscle tissue figure in resting metabolism. Some are genetic and immutable. You may have been born with the ability to burn a lot of energy quickly and effortlessly, while others have what’s called a “sluggish metabolism”and don’t use energy at a very fast rate. It’s interesting to consider the cultural value judgment in using the term “sluggish”; from a scientific perspective, the person with a slower metabolism is much more efficient, a trait that would have been highly prized in earlier times when food was harder to come by.

Zinc Zinc has significant effects on male sexuality, including sperm motility and production, erections, and even testosterone levels. Because the transformation of androstenedione to testosterone depends on a zinc-dependant enzyme, zinc intake significantly affects testosterone levels in the body. One study found that sixty milligrams of zinc daily for fifty days increased serum testosterone levels. Because DHT is metabolized from testosterone, a subsequent rise in DHT levels was also seen. Testosterone and DHT levels only increased in those men whose testosterone levels were low. Normal men experienced no increase.

Refined added sugar causes astronomically more deaths and disability per year than COVID-19 and fentanyl overdoses combined. We need to see refined added sugar for what it is: an addictive, dangerous drug that has been included in 74 percent of foods in the U.S. food system and for which the body needs zero grams in a lifetime. Of all the levers most damaging our cells and preventing Good Energy, I believe the worst offender may be added sugar. This substance has become a mainstay of food that we and our children eat regularly. As Dr. Robert Lustig has noted, sugar shows up on labels in fifty-six different names and sneaks in everywhere.

Downstairs in the body, sleep restocks the armory of our immune system, helping fight malignancy, preventing infection, and warding off all manner of sickness. Sleep reforms the body’s metabolic state by fine-tuning the balance of insulin and circulating glucose. Sleep further regulates our appetite, helping control body weight through healthy food selection rather than rash impulsivity. Plentiful sleep maintains a flourishing microbiome within your gut from which we know so much of our nutritional health begins. Adequate sleep is intimately tied to the fitness of our cardiovascular system, lowering blood pressure while keeping our hearts in fine condition.

that drinking diet soda was associated with a 43 percent increase in risk of vascular events (strokes and heart attacks). The 2008 Atherosclerosis Risk in Communities Study (ARIC)10 found a 34 percent increased incidence of metabolic syndrome in diet soda users, which is consistent with data from the 2007 Framingham Heart Study,11 which showed a 50 percent higher incidence of metabolic syndrome. In 2014, Dr. Ankur Vyas from the University of Iowa Hospitals and Clinics 12 presented a study following 59,614 women over 8.7 years in the Women’s Health Initiative Observational Study. The study found a 30 percent increase risk of cardiovascular events (heart attacks and

Thermoneutrality”: A hallmark of modern industrial life is spending most of our time indoors at relatively consistent ambient temperatures, a concept we’ll refer to as thermoneutrality. Interestingly, experiencing swings in temperature is great for mitochondrial function, as cold stimulates the body to generate more warmth by increasing mitochondrial activity and stimulates more ATP generation and use. Heat exposure has been shown to activate heat shock proteins (HSPs) within cells, which can protect mitochondria from damage and help to maintain their function. HSPs can also stimulate the production of new mitochondria and improve their efficiency in producing ATP.

Like everything else in life, we should eat consciously. We should learn to listen to our body about what to eat and how much – not too much, not too little, the foods which will not strain or poison our system. If the channel of communication is clear between our body and mind, it will tell us what we need for our body type, age, and level of activity while taking into account any health issues or changed circumstances which affect our metabolism. We can still treat ourselves with things we love, but we should do so in honest moderation and with awareness. Eating what is right for our individual system keeps our body healthy and active, and our mind awake and alert. 

Our modern diets and lifestyles are synergistically ravaging our mitochondria. Our mitochondria and the greater cells that house them co-evolved over eons in relationship with our environment. Their mechanisms work in connection with a combination of inputs and information that come from the outside world into our bodies and ultimately into them. Certain kinds of nutrients, sunlight, and information from bacteria in the gut, among other things, all help trigger or supply the cells and their powerhouses with what they require to work. But many of those inputs and information streams have changed radically, resulting in blocks to proper mitochondrial function and downright damage to

Going without food for even a day increases your brain’s natural growth factors, which support the survival and growth of neurons. Evolution designed our bodies and brains to perform at their peak as hybrid vehicles. Metabolic switching between glucose and ketones is when cognition is best and degenerative diseases are kept at bay. As a recent paper in Nature Reviews Neuroscience put it: “Metabolic switching impacts multiple signaling pathways that promote neuroplasticity and resistance of the brain to injury and disease.” So how do you do it? Not by overloading on glucose or ketones, but by altering the cadence of eating and letting the body do what it was designed to do during times of food scarcity.

Life expectancy has increased primarily because of sanitation practices and infectious disease mitigation measures; because of emergency surgery techniques for acute and life-threatening conditions, like an inflamed appendix or trauma; and because of antibiotics to reverse life-threatening infections. In short, almost every “health miracle” we can point to is a cure for an acute issue (i.e., a problem that would kill you imminently if left unresolved). Economically, acute conditions aren’t great in our modern system, because the patient is quickly cured and no longer a customer. Starting in the 1960s, the medical system has taken the trust engendered by these acute innovations and used it to ask patients not to question its authority on chronic diseases (which can last a lifetime and thus are more profitable).

question that our system can produce positive results when focused on the right problem. U.S. hospitals today are filled with some of the world’s most dedicated, intelligent, and hardworking professionals. But they are operating in a system that has lost its way, one that now makes money when patients are sick and loses money when they are healthy. The modern medical system has systematically, overwhelmingly, and unequivocally let us down in preventing and reversing chronic disease. In fact, if you pull out deaths from the top eight infectious diseases (which were decreased by antibiotics) from historical data, life expectancy rates haven’t improved much in the past 120 years—despite, of course, the fact that health care is the largest and fastest-growing industry in the United States—with the vast majority of health care dollars going to chronic disease care.

We have witnessed hundreds of clients and patients damage their metabolic and hormonal health through low-carb diets. It is becoming increasingly apparent that there is an epidemic of metabolic and hormonal dysfunction emerging in the hordes of people who have been following low-carb diets. This is particularly impactful for women—and especially physically active women—who commonly suffer side effects from their low-carb diets, including: A stopped or irregular menstrual cycle (amenorrhea)418 419 420 421 422 Decreased fertility423 424 425 Hypoglycemic episodes and blood sugar swings426 Depression, anxiety, and irritability427 428 429 Poor libido430 431 432 Disrupted sleep/insomnia433 434 Dysfunctional relationship with food and fear about eating either fat or carbohydrate435 436 Cycles of restriction and binges437 438 Chronic fatigue 439 440 441 442 Poor thyroid function (and a slow metabolism)443 444 445 446 447 448

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.

The second is that our food is being transported over large distances, causing degradation and damage to nutrients. The average distance that produce travels from farm to plate in the United States is approximately fifteen hundred miles. During this journey, some fruits and vegetables can lose up to 77 percent of their vitamin C content, a critical micronutrient for ATP production in the mitochondria and antioxidant activity in the cell. You may have thought that “eating local” or shopping from farmers’ markets is frivolous, but it is actually a critical step to ensure you are getting maximal helpful molecular information in the bites you take to build and instruct your body. The third is that most of our U.S. calorie consumption is ultra-processed foods, stripped of their nutrition. About 60 percent or more of the calories adults in the nation consume is ultra-processed garbage. You’re looking at just a fraction of that seventy tons meeting the cells’ functional needs. No

For years, exercise scientists have been convinced that the only way to increase mitochondrial density is with aerobic endurance training, but recent studies have proved otherwise. Not only is an increase in the size and number of mitochondria a proven adaptation to HIIT, but the mitochondrial benefit of HIIT goes way beyond size and number. For example, all your mitochondria contain oxidative enzymes, such as citrate synthase, malate dehydrogenase, and succinate dehydrogenase. These oxidative enzymes lead to improved metabolic function of your skeletal muscles—particularly by causing more effective fat and carbohydrate breakdown for fuel and also by accelerating energy formation from ATP. So more oxidative enzymes means that you have a higher capacity for going longer and harder. And it turns out that, according to an initial study on the effect of HIIT on oxidative enzymes, there were enormous increases in skeletal muscle oxidative enzymes in seven weeks in subjects who did four to ten thirty-second maximal cycling sprints followed by four minutes of recovery just three days a week. But what about HIIT as opposed to aerobic cardio? Another six-week training study compared the increase in oxidative enzymes that resulted from either: 1. Four to six thirty-second maximal-effort cycling sprints, each followed by four-and-a-half minutes of recovery, performed three days a week (classic HIIT training) or 2. Forty to sixty minutes of steady cycling at 65 percent VO2 max (an easy aerobic intensity) five days a week The levels of oxidative enzymes in the mitochondria in subjects who performed the HIIT program were significantly higher—even though they were training at a fraction of the volume of the aerobic group. How could this favorable endurance adaptation happen with such short periods of exercise? It turns out that the increased mitochondrial density and oxidative-enzyme activity from HIIT are caused by completely different message-signaling pathways than those created by traditional endurance training.

Weight stigma can contribute to health problems in a number of ways. Perhaps the most obvious one is that it’s stressful to be stigmatized for your size, and stress takes a physical toll on your body. The scientific term for this toll is allostatic load, meaning the cumulative effect of chronic stressors on multiple systems in the body: the cardiovascular system, the sympathetic and parasympathetic nervous systems, and metabolism. Because it looks at the entire body rather than isolated parts, allostatic load has been shown to be a more robust predictor of chronic-disease risk than other markers. And the research is clear that weight stigma has seriously detrimental whole-body effects. One study that followed close to 1,000 participants for ten years found that those who reported experiencing significant weight stigma over that period were twice as likely to have a high allostatic load as those who didn’t—regardless of actual BMI.5 In other words, weight stigma is an independent risk factor for physiological stress.

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.

My general philosophy regarding endurance contains four key points: 1. Build a great aerobic base. This essential physical and metabolic foundation helps accomplish several important tasks: it prevents injury and maintains a balanced physical body; it increases fat burning for improved stamina, weight loss, and sustained energy; and it improves overall health in the immune and hormonal systems, the intestines and liver, and throughout the body. 2. Eat well. Specific foods influence the developing aerobic system, especially the foods consumed in the course of a typical day. Overall, diet can significantly influence your body’s physical, chemical, and mental state of fitness and health. 3. Reduce stress. Training and competition, combined with other lifestyle factors, can be stressful and adversely affect performance, cause injuries, and even lead to poor nutrition because they can disrupt the normal digestion and absorption of nutrients. 4. Improve brain function. The brain and entire nervous system control virtually all athletic activity, and a healthier brain produces a better athlete. Improved brain function occurs from eating well, controlling stress, and through sensory stimulation, which includes proper training and optimal breathing.

Despite these trends, our culture pushes a Bad Energy world onto kids who cannot protect themselves. Our culture has normalized giving one-year-olds packaged, ultra-processed foods like cake, Goldfish, rice puffs, juice, and french fries. We slather toxic, artificially scented lotions and shampoos all over their tiny bodies as soon as their first hospital bath. We damage their livers and antioxidant capacity with too much acetaminophen (Tylenol) at the first sign of fussiness or a cold. We blast their microbiomes with heavy-duty antibiotics at the first sign of a possible ear infection. And we interrupt their sleep for unconscionably early school times, then force them to sit at desks in school for six or more hours a day. We create terror and chronic stress in their bodies from social media and overall media exposure. The world kids live in is inflammatory and metabolically disastrous unless parents staunchly go against the tide of “normal” American culture. The irony is that so many parents wish that parenting were easier—fewer infections, less colic, easier behavioral patterns—without thinking through the lens of energy production in their children’s bodies. We can do so much to make our lives and our kids’ lives easier by controlling the controllable.

Yet there are problems with speeding up whole-grain bread, and they begin with the flour. Many if not most of the new whole-grain white breads on the market are made with a new variety of hard white wheat developed by ConAgra. This is why the bread doesn’t look like whole wheat: the specks of bran are white, or whitish. They are also microscopic: The wheat is milled by ConAgra using a patented process called Ultrafine that attains a degree of fineness never before achieved in a whole-grain flour. This resulting flour, called Ultragrain, makes for a softer, whiter whole-grain bread, but at a price. It is metabolized almost as fast as white flour, obviating one of the most important health advantages of whole grains: that our bodies absorb and metabolize them slowly, and so avoid the insulin spikes that typically accompany refined carbohydrates. A common measure of the speed by which a food raises glucose levels in the blood (and therefore insulin, an important risk factor for many chronic diseases) is the glycemic index. The glycemic index of a whole-grain Wonder Bread (around 71) is essentially the same as that of Classic Wonderbread (73). (By comparison, the glycemic index of whole-grain bread made with stone-ground flour is only 52.) So perhaps we really have gotten too smart for our own good. Using

and I am convinced that healthy emotional boundaries—such as being clear and vocal about what you will and will not let into your life—are what make relationships functional. Your gut lining is a boundary between you and everything else in the universe that is poised to inundate and overwhelm your biology and generate unrelenting inflammation. Healing and strengthening your gut lining with food—therefore creating and strengthening this critical boundary and reducing intestinal permeability or “leaky gut”—allows you to be selective about what you want to take in from the universe on a material level. You can choose what serves you. I reflect on the fact that many of the problems in society—including violence, mental illness, developmental issues, and pain—start in humans, and humans are made by cells that become dysfunctional largely because of oxidative stress, mitochondrial dysfunction, and chronic inflammation. How miraculous that food can directly combat those things. We can’t have a healthy society without well-functioning humans. We can’t have well-functioning humans without well-functioning cells. And we can’t have well-functioning cells with mitochondrial dysfunction, oxidative stress, chronic inflammation, and cellular and hormone disruption from toxic chemicals in our food. We combat those things through nutrient-dense, unprocessed foods grown in living, thriving soil.

RESISTANCE TRAINING SHOULD HAVE BEEN INVENTED FOR WOMEN. The fitness industry has been plagued with more myths than ancient Greece. One of the most glaring is that women who weight train will look like Mr. Universe. There are still many women who are sidetracked by this common misperception, thereby avoiding weights altogether and bypassing the opportunity to achieve a beautiful, shapely body. One of the biggest differences between men and women is their hormone levels and how these hormones behave—most specifically, testosterone. Testosterone bulks up muscle mass in most men. Men have significantly higher testosterone levels than women, and therefore increasing muscle mass for men is much easier. The vast majority of women cannot build huge, bulging muscles because they have a tiny fraction of the testosterone found in men. There are so many benefits to resistance training for both men and women, but the some of the benefits are very specific to women’s health. For women, the truth is that resistance training increases your metabolism so that you burn fat more easily (and women tend to carry more body fat than men), you build bone mass and prevent osteoporosis (which affects more women than men), and you balance your hormones (which tend to fluctuate wildly in women as they age). Also, women who do resistance training feel a boost in self-esteem and gain renewed physical and mental strength because of their new sexy shape. Resistance training is a woman’s best friend. I rest my case.

DRY SAUNA Numerous cultures use sweat lodges, steam baths, or saunas for cleansing and purification. Many health clubs and big apartment buildings have saunas and steam baths, and more and more people are building saunas in their own homes. Low-to-moderate-temperature saunas are one of the most important ways to detoxify from pesticide exposure. Head-to-toe perspiration through the skin, the largest organ of elimination, releases stored toxins and opens the pores. Fat that is close to the skin is heated, mobilized, and broken down, releasing toxins and breaking up cellulite. The heat increases metabolism, burns off calories, and gives the heart and circulation a workout. This is a boon if you don’t have the energy to exercise. It is well known in medicine that a fever is the body’s way of burning off an infection and stimulating the immune system. Fever therapy and sauna therapy are employed at alternative medicine healing centers to do just that. The controlled temperature in a sauna is excellent for relaxing muscular aches and pains and relieving sinus congestion. The only way I made it through my medical internship was by having regular saunas to reduce the daily stress. FAR-INFRARED (FIR) SAUNAS FIR saunas are inexpensive, convenient, and highly effective. Detox expert Dr. Sherry Rogers says that FIR is a proven and efficacious way of eliminating stored environmental toxins, and she thinks everyone should use one. There are one-person Sauna Domes that you lie under or more elaborate sauna boxes that seat several people. The far infrared provides a heat that increases the body temperature but the surrounding air is not overly heated. One advantage of the dome is that your head remains outside, which most people find more comfortable and less confining. Sweating begins within minutes of entering the dome and can be continued for thirty to sixty minutes. Besides the hundreds of toxins that can be removed through simple sweating, the heat of saunas creates a mild shock to the body, which researchers feel acts as a stimulus for the body’s cells to become more efficient. The outward signs are the production of sweat to help decrease the body temperature, but there is much more going on. Further research on sauna therapy is destined to make it an important medical therapy.

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.

Green tea increases your metabolism and speeds up the process of weight loss, along with fighting cavities in your teeth, decreasing cholesterol and reducing the risk of cancer.

We often assume that maintaining a normal weight is a sign of health, but in reality scientists have found that 24 percent of normal-weight people have chronic diseases that are often attributed only to people who are obese.

Make a conscious point to actively ENJOY every bite of the stuff that you’ve conditioned yourself to believe is unhealthy with intense focus every time you decide to eat it.

HIT is much better than aerobics for fat loss, lean gains, and improvement in insulin sensitivity and metabolic health

Bile is not ONLY the real key to the body’s ability to digest and assimilate fats, but it is also a vehicle for removing toxins from your body so they can be flushed out through the colon.

Abundant data support the importance of biodiversity in health, and its loss causes various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases, type 1 diabetes, liver disease, obesity, and much more.

1. GROWTH HORMONES IN MEAT When you eat conventional meat, you’re probably eating hormones, antibiotics, steroids, and chemicals created by the fear and stress suffered by the animal during slaughter and in its inhumane living conditions. In 2009, two Japanese researchers published a startling study in Annals of Oncology. They pointed out that there has been a surge in hormone-dependent cancers that roughly parallels the surge of beef consumption in Japan. Over the last twenty-five years, hormone-dependent cancers such as breast, ovarian, endometrial, and prostate cancer rose fivefold in that country. More than 25 percent of the beef imported to Japan comes from the United States, where livestock growers regularly use the growth hormonal steroid estradiol. The researchers found that US beef had much higher levels of estrogen than Japanese beef because of the added hormones. This finding led them to conclude that eating a lot of estrogen-rich beef could be the reason for the rising incidence of these life-threatening cancers. Injected hormones like estrogen mimic the activity of our natural hormones and prevent those hormones from doing their jobs. This situation creates chaos. Growth hormones may alter the way in which natural hormones are produced, eliminated, or metabolized. And guess what? Hormone impersonators can trigger unnatural cell growth that may develop into cancer. The United States is one of the only industrialized countries that still allows their animals to be injected with growth hormone. Australia, New Zealand, Canada, Japan, and the entire European Union have banned rBGH and rBST because of their dangerous impact on human and bovine health. US farmers fatten up their livestock by injecting them with estrogen-based hormones, which can migrate from the meat we eat to our bodies—and possibly stimulate the growth of human breast cancer, according to the Breast Cancer Fund, an organization committed to preventing breast cancer by

Stress makes a person fat primarily because of an excessive secretion of the key stress hormone, cortisol, along with a reduced secretion of key anabolic hormones, such as DHEA, testosterone, and growth hormone. This combination of highly catabolic cortisol and reduced anabolic hormones causes the body to store fat, lose muscle, slow metabolic rate, and increase appetite—all of which have the ultimate effect of making a person fatter.

People with disrupted cortisol-secretion patterns have higher body fat (particularly in the abdomen), lower muscle mass (particularly in the arms and legs), and reduced basal metabolic rate (BMR, the number of calories burned at rest).

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

The single most important requirement to improve your fat metabolism and succeed with long-term weight management is to reduce the total amount of insulin you produce. High insulin levels promote fat storage and disease. Moderated insulin levels (typical of Primal Blueprint eating) stimulate fat burning and good health. It’s that simple.

FIT: Overall lean frame gained due to regular planned exercising and balanced diet...having the right metabolism.

Scientific research is validating the connection between lack of sleep and hormone levels that hamper fat metabolism or increase appetite.

Someone starts out sedentary, overweight, and somewhat insulin resistant. They set out to improve their health and lose some weight by following a low-carb diet. It works great. They lose weight, their insulin sensitivity improves, and their energy is through the roof. They start exercising, which helps them lose some more weight, as well as build some lean muscle mass. Now they are really into it, and the frequency and intensity of their training increases. This individual is now at a healthy weight (or relatively lean), is exercising regularly, and has better insulin sensitivity. They are a completely different person, metabolically speaking, then when they started. But the problem is they are no longer properly fueling their body and recovering from their intense training sessions (which were once non-existent). They are starting to feel tired and fatigued in the gym, are always in a bad mood, are holding on to stubborn body fat, can’t sleep at night, get sick all of the time, and are maybe having some sexual performance and hormonal issues. Their diet no longer matches their new activity levels and current metabolic condition, because those have completely changed over time. If this person objectively looked at their situation and progress and listened to their own body and biofeedback, they would consider some dietary adjustments. A moderate-to-higher carb intake might be a better fit. But some people will cling to a diet that initially gave them good results, and got them from Point A to Point B, thinking it will get them from Point B to Point C. I’ve been there myself. Part of it is initial experience, part of it is marketing material, and part of it is pure emotion. It doesn’t always work that way for continued progress.

Another class of fats that warrant concern are polyunsaturated fatty acids, also known as PUFAs. Excessive intake of PUFAs, (found in industrial oils such as canola, corn, safflower, and soybean; margarine and buttery sprays and spreads; and assorted baked, frozen, packaged and processed foods) can also compromise health. These fats also oxidize easily and may contribute to systemic inflammation, as the immune system tries to deal with the oxidation. They may be a major factor in arterial oxidation and inflammation. Your endocrine system is especially sensitive to PUFA consumption, which can lead to symptoms such as a slowed metabolism, low energy levels, and sluggish thyroid function.

Gary Taubes, Why We Get Fat: And What to Do About It (New York: Anchor Books, 2010). For an expanded discussion of Taubes’s arguments, see Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (New York: Anchor Books, 2008). It includes a helpful summary of Taubes’s conclusions (p. 454): 1. Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization. 2. The problem is the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis—the entire harmonic ensemble of the human body. The more easily digestible and refined the carbohydrates, the greater the effect on our health, weight, and well-being. 3. Sugars—sucrose and high-fructose corn syrup, specifically—are particularly harmful, probably because the combination of fructose and glucose simultaneously elevates insulin levels while overloading the liver with carbohydrates. 4. Through their direct effect on insulin and blood sugar, refined carbohydrates, starches, and sugars are the dietary cause of coronary heart disease and diabetes. They are the most likely dietary causes of cancer, Alzheimer’s disease, and the other chronic diseases of civilization. 5. Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior. 6. Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller. Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger. 7. Fattening and obesity are caused by an imbalance—a disequilibrium—in the hormonal regulation of adipose tissue and fat metabolism. Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation. We become leaner when the hormonal regulation of the fat tissue reverses this balance. 8. Insulin is the primary regulator of fat storage. When insulin levels are elevated—either chronically or after a meal—we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel. 9. By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume, the leaner we will be. 10. By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity. For a fascinating discussion of the role of fat in a healthy diet, see also Nina Teicholz, The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet (New York: Simon & Schuster, 2014).