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
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.
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 triglyceri
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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.
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
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
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.
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.
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
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.
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.