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

The incentives of our medical and food systems pressure patients to not ask questions. These incentives also lead to the biggest lie in healthcare. That the reasons we are getting sicker, fatter, more depressed, and more infertile are complicated. The reasons are not complicated. They all tie to good energy habits.

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.

Nearly every doctor I worked with dreamed as a child about curing disease and worked like crazy to become a doctor. They studied tirelessly to learn science, entered medical school with idealistic visions, and became the pride of their family. They entered residency with hundreds of thousands of dollars of student loan debt and initially saw the chronic sleep deprivation and verbal abuse by their superiors as integral parts of the experience — because “great achievement is born of great sacrifice.” But almost universally among doctors I have met, this idealism eventually turns to cynicism. My colleagues in residency talked often about questioning their sanity, of wondering whether this was all worth it. I spoke with successful surgeons who’d drafted their resignation letters dozens of times. Another had a recurring daydream of leaving everything behind and becoming a baker. Many of my supervising physicians were desperate to spend more time with their children. I witnessed more than one tearful breakdown in the operating room when surgical cases were delayed and led to yet another missed bedtime for their kids. Several had dealt with suicidal depression. I understood why doctors had the highest burnout and suicide rate of any profession. Inevitably, these conversations led to an insight that I believe is whispered by doctors in every hospital in America: they feel trapped inside a broken system.

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Nutrition Eliminate refined added sugars Eliminate all foods, drinks, and condiments with refined or liquid sugars. Added sugars may include the following names: white sugar, brown sugar, powdered sugar, cane sugar, evaporated cane juice, raw sugar, turbinado sugar, demerara sugar, coconut sugar, maple syrup, honey, molasses, agave nectar, corn syrup, high-fructose corn syrup, glucose, dextrose, fructose, maltose, sucrose, galactose,

Your doctor, and the entire system they work within, directly and unequivocably benefits from your continued suffering, symptoms, and sickness. Your doctor also likely doesn’t understand the role they play in this medical billing industrial complex. Or the economic and political puppet strings controlling their educational curriculum, the research literature around nutrition, and their decision-making.

Patients are being crushed by the devil’s bargain. Between the 6 trillion dollar food industry which wants to make food cheap and addictive and the 4 trillion dollar health care industry which profits off interventions on sick patients and stays silent about the reasons they are getting sick.

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.

GOOD ENERGY BIOMARKERS AND MOVEMENT When you’re striving to be part of the 6.8 percent of metabolically healthy Americans, regular movement will help you get there. Research shows that exercise improves all five of the following basic biomarkers of metabolism: Glucose Levels Above 100 mg/dL: Twelve-week exercise programs of either high-intensity running (40 minutes per week) or low-intensity running (150 minutes per week) both brought participants’ blood sugar from the prediabetic range (100 mg/dL or greater) to the nondiabetic range (<100 mg/dL). HDL Cholesterol Less Than 40 mg/dL: A 2019 review of the literature showed that exercise increased HDL cholesterol, “with exercise volume, rather than intensity, having a greater influence.” Meanwhile, “raising HDL levels pharmacologically has not shown convincing clinical benefits.” Triglycerides Above 150 mg/dL: Numerous studies have demonstrated that physical activity effectively lowers triglyceride levels. In a 2019 study, an eight-week moderate aerobic exercise program significantly reduced triglyceride levels in participants. Furthermore, even a single session of intense aerobic exercise has been found to decrease triglyceride levels the following day. This positive effect could be due to the increased activity of hepatic lipase in the liver, an enzyme that facilitates the absorption of triglyceride from the bloodstream. Blood Pressure of 130/85 mmHg or Higher: Research has shown the effects of exercise among populations with high blood pressure were similar to the effects of commonly used medications. A Waistline of More Than 35 Inches for Women and 40 Inches for Men: Not surprisingly, regular exercise can help decrease obesity by increasing energy expenditure and promoting weight loss. Research shows a clear inverse relationship between the amount of movement people do each week and the size of their waistline: more movement, smaller waist circumference. What’s more, lower activity (fewer than 5,100 steps per day)

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.

Liver Enzymes: aspartate transaminase (AST), alanine transaminase (ALT), and gamma-glutamyl transferase (GGT) AST and ALT levels of 17 U/L or less. For GGT, lowest risk for men is less than 25 U/L and women from 14 to 20 U/L. Sources vary slightly, but these are good targets to aim for. Vitamin D 40 to 60 ng/mL Recommended real-time metrics to track: Glucose (continuous glucose monitor) Food (food journal or app) Sleep (quantity, quality, consistency) Activity (steps, number of active minutes per day and week with elevated heart rate) Resting heart rate and heart rate variability

Another way to practice mindfulness at any moment is to close your eyes and scan every sensation in your body: your heartbeat, your butt on the chair, any areas of warmth or cold, your toes on the ground, the air moving into your nose and lungs. Because this body scan forces you into the present moment, it takes you away from mental states of anxiety or stress.

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.

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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.