There is a massive and growing epidemic going on right now, and no I am not referring to the virus that shall not be named.
The great epidemic we are experiencing is that of poor metabolic health, and a pathological state known as ‘insulin resistance’. There are good odds even you, reading this, are insulin resistant to some degree. Our modern society has an overwhelming amount of sick, diseased, overweight humans and it is a massive burden to all life on earth through widespread chronic health problems, environmental destruction, political and scientific corruption, extreme economic burden, and even social injustice, poverty, and racism. We are living out of tune with nature and it shows. But, I digress; let's take a dive into this epidemic of poor metabolic health and insulin resistance.
First, what is insulin?
Insulin is a hormone that is made in the pancreas, a small organ tucked beneath the stomach. It affects every cell in your body, having different effects on various cells.
Insulin plays many important roles in your body. Perhaps it’s most important role is regulating how your cells use energy. Insulin can also change a cell's size, influence other hormones, and even determine whether cells live or die.
Insulin is mostly known for regulating blood glucose levels. When we eat food that increases blood glucose, the pancreas releases insulin which escorts glucose from the blood to different parts of your body like the heart, brain, muscles, liver, ears, testicles and ovaries, bone, nerves, and fat tissue.
Insulin then effects hearing, heart size, blood pressure, muscle protein production, muscle size, fat storage, fat growth, fat production, normal sex hormone production, and the growth of bone, nerves and neurons.
Insulin is clearly very important in our body… when it is working.
When Insulin Isn’t Working
The general state where insulin begins failing to do its many jobs can be referred to as Insulin Resistance
Pathological Insulin Resistance, which slowly manifests as dysglycemia, pre-diabetes, and diabetes, is the most common health disorder worldwide (and you may have never heard of it).
Insulin resistance is typically associated with type 2 diabetes (when it is fully expressed) but it underlies virtually all chronic modern diseases, especially those that stem from Westernized diet and lifestyle inputs. It is defined as a general reduced response of the body’s cells to the hormone insulin. This reduced response is caused by excess insulin in the body, stemming from aforementioned Western diet/lifestyle inputs; especially chronic consumption of ultra-processed foods (combining excess refined grains and industrial seed oils) and chronic stress.
When any bodily process is excessively activated, the body will dampen the response to the excess stimulation to reduce the activation. In relation to insulin, too much insulin causes insulin resistance. For every 1-microunit of increase in fasting blood insulin a person can experience around a 20% increase in insulin resistance (Marchesini, G., et al 1999)
When a cell stops responding to insulin it is considered ‘resistant’. But the body doesn’t just go from a state of health to full on pathological insulin resistance. It is a long, drawn out process requiring years of consistent Western diet/lifestyle inputs, with increasing degrees of insulin resistance throughout the body as time goes on. Insulin resistance can be developing for years before it results in blood sugar issues like hyperglycemia.
As more cells become resistant to insulins signal, the body as a whole can then be considered insulin resistant. In this abnormal state, cells will require larger amounts of insulin to produce the same response as in a normal state. Blood levels of insulin will be higher, and the body will eventually fail to respond properly to it. This describes type 2 diabetes- full blown insulin resistance that has progressed to the point where the body cannot keep blood glucose levels below 7 mmol/L.
Your cells then struggle to regulate energy use, resulting in the storage of body fat as your fat cells are stuffed full (hypertrophy), eventually leading to dangerous visceral fat accumulation, pathological blood sugar/lipid imbalances, and systemic inflammation.
The downstream result of that process is metabolic dysfunction in the whole body and a greatly increased risk of developing most chronic diseases.
To give some perspective to its prevalence, here are some key facts about pathological insulin resistance in Canada.
1 in 3 Canadians has either diabetes (2.4 million Canadians) or pre-diabetes.
Those who are currently 20 years old have a 50% risk of developing diabetes in their lifetime.
Its prevalence has increased twofold in the last decade, and the management of it costs $9 billion annually.
Here are some disturbing key facts from two major reports that mapped out the impact of poor metabolic health caused by the current food system in the US (Waters H, Graf M. 2018- October/May):
Direct healthcare costs for chronic health conditions in the US was $1.1 trillion in 2016. Indirect healthcare costs were another 2.6 trillion. Combined, the costs are $3.7 trillion, or 1 in 5 dollars of the whole US economy. Every year!
60% of Americans have one chronic disease, and 40% have 2 or more.
70% of Americans are either overweight or obese, and 40% are obese.
Most Americans (88%) meet one or more of the criteria of poor metabolic health. (Araujo, J., J. Cai and J. Stevens 2019)
Over 2 billion people worldwide are obese and overweight. (Murray CJL, et al 2017)
When you think about it globally and holistically, the costs of poor metabolic health are astronomical.
Interestingly, ethnicity also seems to play a role in the development of insulin resistance, and many communities with lower socioeconomic status can be especially impacted by poor metabolic health.
Insulin Resistance seems to develop the fastest (in the following order and regardless of hip to waist ratio in these different ethnicities) in Hispanic, Asian, Black, Caucasian or Northern European. (Chiu, K.C., et al 2000) Caucasian people can generally get much fatter before metabolic dysfunction sets in, and the onset can be much quicker in other ethnicities.
First Nations, Native Hawaiians, Pacific Islanders, and Asians are twice as likely to get diabetes than a caucasian person. (Wheeler SM, Bryant AS. 2017)
In the US over the last decade, type 2 diabetes has tripled in First Nations children, doubled in black children, and increased by 50% in hispanic children.(Mayer-David EJ, Lawrence, JM, Dabelea D, et al. 2017)
If you are black, you are also 4x as likely to experience kidney failure, and 3 ½ x more likely to suffer amputations than caucasain people. (Wheeler SM, Bryant AS. 2017)
In Canada, its prevalence is 3-5 times higher in First Nations people than Non-First Nations people.
Also, as an important and presently relevant side note, your metabolic health and your immune system health are intimately connected, and your metabolic health may even determine the severity of Covid-19 symptoms and outcomes should you contract it. (1,2,3,4) Based on the above statistics, Covid-19 is truly dangerous to many individuals in the western world, due to the prevalence of poor metabolic health.
But on the bright side, improving your metabolic health is very achievable and can be improved quicker than you might think! It is possible that many individuals experiencing multiple and seemingly diverse health problems could make health improvements by addressing this one root cause; since pathological insulin resistance has a hand in a number of serious health conditions. In fact, the list is staggering!
When you begin to view your diet and lifestyle through the lens of insulin and insulin resistance, you are more likely to be addressing a root cause of multiple, and seemingly diverse, health problems. Insulin resistance, poor metabolic health, and Western diets and lifestyles all play key roles in chronic disease. The good news is that state of poor metabolic health is 100% preventable and reversible.
Holistic healthy living is the best way to combat metabolic health challenges. When you eat and live in a way that produces health and vitality, you don’t just improve your personal health; you improve our economic health, the health of our communities, and the health of our planet and all its beings.