Why We Get Sick

1. Insulin resistance is the hidden epidemic behind chronic diseases

"Insulin resistance is the epidemic you may have never heard of."

Prevalence and impact. Insulin resistance affects up to 88% of adults in the United States and is a precursor to numerous chronic diseases. It's linked to heart disease, cancer, Alzheimer's, and other conditions that are becoming increasingly common. Despite its prevalence, many people and even some healthcare professionals are unaware of its significance.

Symptoms and diagnosis. Common signs of insulin resistance include:

• Excess belly fat
• High blood pressure
• High triglycerides
• Skin tags or dark patches (acanthosis nigricans)
• PCOS in women or erectile dysfunction in men

To diagnose insulin resistance, doctors should measure fasting insulin levels, not just glucose. A fasting insulin level above 6 µU/mL indicates potential insulin resistance.

2. Excess insulin, not just glucose, is the root cause of metabolic disorders

"To get a sense of your risk level, answer these questions: Do you have more fat around your belly than you'd like? Do you have high blood pressure?"

Insulin's role. Insulin is a hormone that regulates blood glucose, but it also affects every cell in the body. When insulin levels are chronically high, cells become resistant to its effects, leading to a vicious cycle of increasing insulin production and decreasing sensitivity.

Beyond glucose. While most diagnostic focus has been on blood glucose levels, insulin itself is a more important indicator of metabolic health. Excess insulin can cause:

• Increased fat storage, especially around the abdomen
• Inflammation and oxidative stress
• Altered hormone balance
• Impaired cellular function across multiple organs

3. Insulin resistance affects multiple organs and systems in the body

"From the brain to the toes, insulin regulates how a cell uses energy, changes its size, influences production of other hormones, and even determines whether cells live or die."

Widespread effects. Insulin resistance impacts various bodily systems:

Cardiovascular system:

• Increases blood pressure
• Alters cholesterol composition
• Promotes atherosclerosis

Brain:

• Contributes to Alzheimer's disease (sometimes called "type 3 diabetes")
• Affects mood and cognitive function

Reproductive system:

• In women: PCOS, fertility issues
• In men: Low testosterone, erectile dysfunction

Skin:

• Acanthosis nigricans (dark skin patches)
• Skin tags
• Increased acne

Digestive system:

• Non-alcoholic fatty liver disease
• Increased risk of gallstones

4. Lifestyle factors, especially diet, are primary drivers of insulin resistance

"The epidemics of obesity and insulin resistance are partly the product of bending science to fit politics."

Dietary misconceptions. For decades, the focus on low-fat diets has led to increased consumption of refined carbohydrates and sugars, which spike insulin levels. This approach, based more on politics than sound science, has contributed significantly to the rise in insulin resistance.

Key dietary factors:

• Excess sugar and refined carbohydrates
• High fructose consumption
• Frequent snacking and constant eating
• Lack of fiber-rich whole foods

Other lifestyle contributors:

• Sedentary behavior
• Chronic stress
• Poor sleep quality and quantity
• Exposure to environmental toxins

5. Carbohydrate restriction is key to reversing insulin resistance

"When it comes to diet, we got it wrong."

Carb control. Limiting carbohydrate intake, especially refined carbs and sugars, is crucial for managing insulin levels. This approach:

• Reduces insulin spikes
• Promotes fat burning
• Improves metabolic flexibility

Beneficial foods:

• Non-starchy vegetables
• High-quality proteins
• Healthy fats (e.g., avocados, olive oil, nuts)
• Low-glycemic fruits in moderation

Meal composition. Aim for:

• 55-70% calories from fat
• 20-30% from protein
• 5-20% from carbohydrates (depending on individual insulin sensitivity)

6. Exercise and sleep play crucial roles in insulin sensitivity

"Movement matters."

Exercise benefits. Physical activity improves insulin sensitivity by:

• Increasing muscle glucose uptake independent of insulin
• Reducing inflammation and oxidative stress
• Promoting fat loss, especially visceral fat

Exercise recommendations:

• Combine aerobic and resistance training
• Aim for high-intensity intervals for maximum benefit
• Move frequently throughout the day to break up sedentary periods

Sleep importance. Poor sleep quality or insufficient sleep duration can rapidly induce insulin resistance. Prioritize 7-9 hours of quality sleep per night and maintain consistent sleep-wake cycles.

7. Fasting and time-restricted eating can improve insulin function

"Having prolonged periods during the day where glucose and insulin are low is a vital step in the right direction."

Fasting benefits. Periodic fasting or time-restricted eating can:

• Lower baseline insulin levels
• Improve insulin sensitivity
• Promote autophagy and cellular repair
• Enhance metabolic flexibility

Fasting strategies:

• 16/8 intermittent fasting (16 hours fasting, 8 hours eating window)
• 24-hour fasts once or twice a month
• Extended fasts under medical supervision

Cautions: Start gradually and consult a healthcare provider, especially if you have pre-existing health conditions.

8. Environmental toxins contribute to insulin resistance

"We breathe constantly, taking roughly 20,000 breaths per day. Because of this, what we breathe can profoundly affect our health."

Common toxins:

• Air pollution (especially PM2.5 particles)
• Cigarette smoke (including secondhand and thirdhand smoke)
• Endocrine disruptors in plastics and personal care products
• Pesticides and herbicides

Mitigation strategies:

• Use air purifiers in your home
• Choose organic produce when possible
• Avoid plastic food containers and non-stick cookware
• Filter your drinking water

9. Insulin resistance is reversible through targeted lifestyle changes

"Fight the resistance!"

Holistic approach. Reversing insulin resistance requires a multi-faceted strategy:

1. Diet:

   • Restrict carbohydrates
   • Increase healthy fats and proteins
   • Focus on whole, unprocessed foods

2. Exercise:

   • Combine aerobic and resistance training
   • Incorporate high-intensity intervals
   • Move frequently throughout the day

3. Sleep and stress management:

   • Prioritize 7-9 hours of quality sleep
   • Practice stress-reduction techniques (meditation, deep breathing)

4. Fasting:

   • Implement time-restricted eating or intermittent fasting

5. Toxin reduction:

   • Minimize exposure to environmental pollutants

6. Regular monitoring:

   • Track fasting insulin levels and other metabolic markers

By addressing these factors, it's possible to improve insulin sensitivity, reverse metabolic dysfunction, and significantly reduce the risk of chronic diseases associated with insulin resistance.

Last updated: January 23, 2025