The root cause underlying the problem is the excess of calorie-dense, nutrient-poor, toxic stuff masquerading as food, which essentially blocks the insulin receptors on the muscles and the liver and in the blood vessels. This causes serious difficulty with fuel delivery and utilization, incapacitating our energy-delivery system. These tissues essentially become “accessory fuel tanks” as we live in a constant state of feast without giving the system a chance to burn off the extra fuel.
Table 1.1 summarizes how physicians diagnose metabolic syndrome. Increased waist circumference plus any two of the criteria in the table results in the diagnosis. Metabolic syndrome is so dangerous because abdominal obesity (midsection or “belly” fat) produces harmful substances that cause inflammation and damage circulation and internal organs.
As stated above, your entire bloodstream can only handle three to four teaspoons of sugar at a time. Actually, the total amount of sugar you should consume in a day is zero teaspoons because refined sugar does not exist in nature. The body can extract all the sugar it needs from real unprocessed plant foods.
Table 1.1. Diagnosis of metabolic syndrome (a diagnosis includes increased waist circumference and any two other risk factors)
The Role of Insulin
Insulin is the glucose-disposal hormone that is designed to move sugar from your bloodstream to your muscles to be used as energy. In fact, muscle is the largest insulin-sensitive tissue in the body. So one way to increase insulin sensitivity is to activate your muscles! Using our car analogy, insulin acts as the fuel injectors, supplying glucose (fuel) to the engine (muscles, brain, and other vital organs). Our insulin level soars when we both consume a high-calorie, low-nutrient diet — a diet high in manufactured, processed food that is mostly refined carbohydrates (sugar, high-fructose corn syrup, and white flour) and unhealthy fat (feedlot meat, cheese, industrially prepared vegetable oils) and low in fiber and micronutrients — and couple it with a sedentary lifestyle, high stress, and lack of sleep. In response to constantly elevated insulin levels, the cells, tissues, and organs become insulin resistant or insensitive. This is like how we “tune out” and no longer hear a constant sound, like a fan or traffic outside our window.
As shown in figure 1.2, constant and repeated spiking of blood glucose from a toxic diet of highly processed foods loaded with refined carbohydrates (such as from refined grain flours, sugar, and high-fructose corn syrup) leads to a constant elevation of insulin levels. With repeated glucose spikes, insulin levels have no chance to retreat to normal levels. This constant elevation of insulin makes us constantly hungry and leads to metabolic syndrome and type 2 diabetes. Thus, the formula is, repeated glucose spikes cause constant elevation in insulin levels, which leads to constant hunger and eventually disease. The key is to eat foods that release glucose slowly so that insulin levels stay low.
To summarize, in the presence of high levels of insulin, fat cannot be broken down into free fatty acids to be used for energy. This means that as long as you continue to consume a diet high in sugar and processed carbohydrates, your body will not be able to go to “fat-burning” mode. Thus, persistent elevation of insulin causes high levels of circulating blood glucose as well as fat accumulation. It also starts a perpetual cycle of hunger and cravings for sugar and high-glycemic foods (processed grains = fast carbohydrates = sugar releasing). The glycemic index is the degree to which food is processed to glucose in the body (for a chart of specific foods, see appendix 4). To hop off this cycle, your goal should be to follow a lifestyle that calms these raging insulin levels. Low insulin levels translate to less hunger, fewer weight problems, more fat burn, and less illness. When we provide the body with the right fuel, we begin to correct the hormone imbalances that wreak havoc on the entire system.
Figure 1.2. Blood glucose and insulin levels: With repeated glucose spikes, insulin levels have no chance to retreat to healthy levels
Insulin Resistance
You may wonder: How exactly does it happen that belly fat causes insulin resistance? Here’s how.
In a series of unfortunate events, our modern diet — typically high in sugar, refined starches, and “dirty fat,” such as trans fats and industrially produced oils — plugs the fuel injectors so that glucose can no longer enter the cells. Instead, glucose levels start to mount in the bloodstream. Muscle cells become insulin resistant, initially allowing energy to be stored as fat around the vital organs and in and around the liver. Eventually, these tissues also become insulin resistant. Thus starts the vicious cycle in which belly fat produces insulin resistance, and insulin resistance causes even more belly fat. As the liver and fat tissues also become insulin resistant, full-blown type 2 diabetes ensues with soaring levels of blood glucose.
Central obesity (excess weight in the midsection) produces hormones and other substances that are huge contributors to insulin resistance. Simply put, belly fat produces substances that act like a wad of bubble gum blocking a keyhole. Even though we have the right key (insulin), the door remains locked, and sugar is unable to enter the cells. It remains in the bloodstream, causing damage. Additionally, belly fat produces hormone messengers that make us tired, achy, and sick.
While diabetes is diagnosed by a fasting glucose of over 126 mg/dL, prediabetes is fasting glucose over 99 mg/dL, and insulin resistance starts at fasting glucose above 85 mg/dL.
Prediabetes and insulin resistance can precede type 2 diabetes by a decade. This is why I say that type 2 diabetes is just the tip of the iceberg. By the time we notice it, the main body of the iceberg has existed below our awareness for years. The result can be organ damage, such as eye and nerve damage, and its accompanying complications of full-blown heart disease and kidney disease.
Sugar Glazing, or the Importance of HbA1c
When we experience insulin resistance and too much blood sugar remains in the bloodstream, it causes “sugar glazing” of the hemoglobin in red blood cells. This is called glycation, and it results in glycosylated hemoglobin (also known as glycohemoglobin) or HbA1c. That is, a high level of circulating blood sugar makes the cells in the body, and the vessels through which they flow, “sticky.” Imagine blood cells as Ping-Pong balls flowing through a pipe. Now imagine that the balls and the pipes have been dipped in honey. As they try to flow through the pipes, they damage the lining.
This glycation or “sugar glazing” causes cellular dysfunction and tissue inflammation, leading to degenerative diseases from oxidative stress. In fact, type 2 diabetes is the perfect model for rapid aging.
Advanced glycation end products (aptly abbreviated as AGEs) make not only the red blood cells but all the proteins in the body sticky. They are like the sticky fingers of a toddler, affecting everything they touch. When proteins are sticky, they can no longer properly communicate with one another, leading to the onset of dysfunctions that we typically attribute to aging. In fact, this process of producing advanced glycation end products causes proteins to malfunction and accelerates the aging process.
Indeed, did you know that Alzheimer’s dementia is increasingly believed to be another manifestation of insulin resistance, one that affects the brain instead of other organs? Some investigators have even described it as “type 3 diabetes.”4 It should come as no surprise that the same metabolic conditions that cause heart attacks, strokes, erectile dysfunction, kidney failure, and amputations may also be poisonous to the brain! On the flip side, the lifestyle changes of Turbo Metabolism are