Insulin and Triglycerides

Every time I review someone’s blood test results, and then discuss with them what they mean and what they should do to improve their numbers, there’s something I almost always have to explain. And this was the relationship between fasting insulin and triglyceride levels.

Take a look at this plot:

trigs_vs_insulin_gb

Plot showing ten pairs of measurements of insulin and triglycerides, made from the same blood samples. They were collected between 2011 and 2017, and all are from my own blood tests.

It shows measurements of insulin concentration on the horizontal axis in mili units per millilitre (mIU/ml), and triglyceride levels on the vertical axis in milligrammes per decilitre (mg/dl). This is a correlation plot in which independent measurements of one variable are plotted against independent measurements of another in an attempt to see if there is a relationship between them.

Is there an order in the way the dots are organized? They are clearly not randomly distributed as a circular cloud of dots—it would mean that there is no relationship. Instead, we see what looks like a linear relationship in which lower values of insulin correspond to lower values of triglycerides, and higher values of insulin correspond to higher values of triglycerides. It’s not a straight line, but it’s definitely a clear linear relationship, and the value of the correlation coefficient, which quantifies how tight the relationship actually is, of just under 0.9 is pretty close to 1. In other words, it’s a pretty tight linear relationship.

Triglyceride is a fancy word for fat or lipid, because fat molecules are composed of three fatty acids held together by a glycerol structure. This is what triglyceride refers to. The amount of fat in the blood is affected by the amount of fat we eat, and the amount of body fat we have. Naturally, after a fatty meal, triglyceride levels will increase as the fat goes from the digestive system into the blood, they will reach a maximum, and then start to go down. The longer we wait before we eat again, the lower they will go. But there’s a few complications.

The first is that depending on the amount of insulin, one of whose jobs it is to transport nutrients into cells, whatever is circulating in the blood—and this includes glucose, of course, but also protein and fat—will in general be stored away faster if insulin is higher, and slower if insulin is lower. This means that if you eat fat together with sugar or starch, the whole lot will be packed away, and mostly as fat, minus the little bit of glucose your muscles and liver have room to store up as glycogen.

The second is that depending on the state of insulin sensitivity—the fundamental parameter that determines how well or poorly cells can use fat for fuel—triglycerides will in general be used up faster if we are more insulin sensitive and slower if we are more insulin resistant. This means that in the morning, twelve to fourteen hours after having had the exact same meal, the more insulin sensitive person will have lower triglyceride levels than the more insulin resistant.

And in fact, no matter if we have a measure of fasting insulin or not, and no matter how little we know about the person’s overall health, fasting triglyceride concentration is probably the best general marker of insulin sensitivity. Nevertheless, because their levels fluctuate quite a lot over the course of each day as a function of what we eat and drink, it is true for triglyceride levels as it is true for many other blood tests that are affected by the kind and amount of food and drink we’ve had over the last days, and most importantly by the amount of sweet or starchy carbohydrates.

Now, take a look at this second plot:

trigs_vs_insulin_final

Plot showing, in addition to the 10 points shown in the first plot (in red), another 20 pairs of measurements of insulin and triglycerides, also all from the same blood samples, but from seven other persons.

It shows the same 10 data points shown in the first plot from my own results, but with another 20 pairs of measurements taken from other people that I’ve coached and helped with the interpretation of their results. You can see that the relationship is better defined because of the additional points that now together cover a wider range of values on both axes.

However, you can also see that, the relationship is not as tight. In particular, there are a few points that are quite far off the main trend—mostly those at the top of the plot with high triglyceride and low insulin values. We see how these off-trend points affect the tightness of the relationship seen in the initial data set when we compare the values of the correlation coefficients. These off-trend points lead us to the third complication I wanted to bring up.

But first, please take a minute to consider the matter: What could lead to having low insulin and at the same time high triglycerides? What could be the cause of the difference between my numbers, which did contain some very low insulin levels, but all of which were paired with equally low triglyceride values, and this other person’s numbers? What causes insulin to go down? What happens when insulin is low? What could cause triglycerides to go up while insulin is low?

Insulin, no matter how high it is, will start to go down when we stop eating. The longer we fast, the lower it will go. Each person’s baseline will be a little different depending mainly on their metabolic health and their body fat stores. The more efficient the metabolism is at using fat for fuel—the more insulin sensitive, the lower insulin will go. But also the lower the body fat stores are, the lower insulin will go. On the flip side, the more insulin resistant and the fatter we are, the longer it will take for insulin to drop and the higher it will stay at baseline.

This is pretty shitty. I mean, as we develop insulin resistance, average insulin levels will become higher and higher. As a result we’ll store calories into our growing fat cells more and more easily, and will therefore become fatter and fatter, faster and faster. But fat cells also secrete insulin! So, the more fat cells there are, the higher the insulin levels will be, and the harder it will be to lower our basal insulin. To burn fat, we need to lower insulin levels. The fatter we are, the higher the insulin levels will tend to be. And the fatter we are, the harder it will be to lower insulin levels.

It’s a bit of a catch, but in the end, it’s not such a big deal because basically everyone who is overweight and who starts to fast and restrict carbohydrates melts their fat stores away very well. It works incrementally: insulin goes down a little, insulin resistance is reduced a little, fat-burning starts; insulin goes down a little lower, insulin resistance is further reduced, fat-burning increases; and on it goes, until we have lost all those extra kilos of fat that we were carrying on our body, be it 5, 15, 20, 35, 60 or even 100 kg of fat! It’s just a matter of time.

Now, after this little tangent on insulin and fat stores, we can come back to those anomalous points in the plot, the most conspicuous of which is the one just below 120 mg/dl of triglycerides but only 3 mUI/ml of insulin. Have you come up with an explanation? Here is mine:

That point is from one of my wife’s blood tests. It is unusual because it was done after 24 hours of fasting. My 24-hour fasting blood test done a number of weeks before, and my numbers were 41 for trigs at 2.3 for insulin. The difference between her and I was that I was already very lean, whereas she wasn’t. Therefore, as she fasted, her insulin levels dropped very low, and then the body started releasing its fat stores into the bloodstream in high gear. This is why her triglyceride levels were this high while her insulin was that low. It’s almost certainly the same for the other two points up there with trigs at 110 and 90 with insulin around 4 and 2.5 (the latter one of which is also my wife’s).

Since we did many of our blood tests around the same time, there are 9 data points from her on the plot. Several are in the centre of the main trend at insulin values between 6 and 7, but I’d like draw your attention to her lowest insulin value that was measured at 1.8, and at which time her trigs were at 57, and her lowest triglyceride level of 48, at which time her insulin was at 2.2. This shows that on average her values are a little further along the trend than mine are because of the small difference in body fat, but that she has good insulin sensitivity, and a well-functioning metabolism that can efficiently use fat for fuel.

The other off-trend point, but in the other direction on the right hand side, with insulin just above 10 and trigs around 65, is from my mother’s first blood test which I ordered and included insulin and trigs, before I got her off carbs. She was 82 at the time, eating a regular kind of diet, but not a very nutritious or varied diet with plenty of bread and cheese, because she had serious problems moving around and taking care of herself while still living alone. And so, it’s just the result of being older, having plenty of carbs, but not being highly insulin resistant nor highly overweight. Her baseline insulin levels were just generally higher because of her age and diet, but her trigs weren’t excessively high.

However, after just four days of intermittent fasting on a very low carb regime with most calories coming coconut oil spiked green juices and coconut milk smoothies, her insulin went from 10.3 to 4.7, and she lost 5 kilos, which, of course, were mostly from the release of water that the body was retaining to counter the effects of the chronic inflammation that immediately went down with the very-low carb regime and fasting.

Later, having sustained this strict green healing protocol for about 6 weeks, her numbers were at 2.9 for insulin and 56 for trigs. And by then she had lost another 5 kg, but this was now mostly fat. She had, at that point, recovered full insulin sensitivity, had lost most of her body fat stores, and overhauled her metabolism. She was 83 at that time, which shows that this sort of resetting of the metabolism can work at any age.

On this note, let’s conclude with these take-home messages:

First, the next time you get a blood test, request that insulin and triglycerides be measured, because it’s the only way to know what your fasting insulin actually is, and because it is very telling of your level of insulin resistance or sensitivity, overall metabolic health, as well as your average rate of ageing as we’ve seen in a previous post on insulin and the genetics of longevity.

Second, when you get the results back, you will be able to tell from your triglycerides concentration, in light of your insulin level, either how well the body is using fat for fuel—in the case you are already lean, or how fast you are burning your fat stores—in the case you still have excess body fat to burn through.

And third, resetting metabolic health can be done at any time and at any age, and is yet another thing that shows us how incredible our body is—the more we learn generally or individually, the more amazing it reveals itself to be.

 

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Ten years of carbohydrate restriction: here’s why

It was almost exactly ten years ago, in March 2008, that I read Ron Rosedale’s Insulin and Its Metabolic Effects.  I now know that this is surely the one thing I’ve read that has had the most impact on my life. Rosedale’s presentation was a total revelation to me:  I had never read anything about insulin before, and his explanations of the biochemical and physiological functions and effects of insulin on the body all made perfect sense in and of themselves, but also appealed to my appreciation and reliance on complete explanations that are consistent with the facts we can observe about them.  I eliminated insulin-stimulating carbohydrates from my diet overnight.  That was that.

We were then still vegetarian at home.  Hence, the family breakfast, following Mercola’s example, became smoothies made of raw, local, pastured eggs with berries and stevia.  That lasted quite a while.  I always travelled with my hand blender and stevia, brought eggs if it was for short trip, or scouted out places to get good ones when the trip was longer.  Throughout a summer trip along the American west coast, I made our raw egg smoothies every day, in hotel rooms and campgrounds.

At one point, I discovered coconut oil and coconut milk.  The breakfast smoothies evolved to being made of eggs and coconut milk with berries, and eventually only coconut milk, berries and stevia.  This period lasted several years until we moved on to cold pressed green juice with coconut milk; it was two thirds juice and one third milk.  We also did this for several years until about two years ago when our son left for university, at which point we dropped having breakfast entirely to allow for a daily overnight fasting period of about 16 hours from after dinner to lunchtime.

Food intolerance testing in 2014 showed that all three of us were intolerant to eggs; we removed them from our diet.  My wife and I had the most and our son the least intolerances; this was not surprising given we were a lot older than him.  It also showed my wife and I were intolerant to most dairy products; we removed them from our diet.  We were also intolerant to grains: both highly intolerant to wheat, and then I, in addition, somewhat less so to barley, malt, and quinoa—we ate quinoa almost daily for years as our son was growing up.  He, although not intolerant to dairy or wheat, was intolerant to almonds, pistachios, and brazil nuts. (Here are my test results, if you’re interested.)

Imagine: vegetarian for 20 years, with a diet during these two decades from teenage hood to middle adult hood consisting primarily of wheat and grain products, beans, cheese and yogurt, eggs and nuts.  Of course, also plenty of sweet fruit, starchy vegetables, and salads, as with is true for most vegetarians.  But the bulk, both in volume and in calories, was from grain products, cheese, and eggs.  The shocker for me was that the food intolerance test painted the profile of a meat-eater:  if you remove grains, dairy, and eggs, what is left is animal flesh, vegetables and fruits.

If now, in addition, you remove (most) fruit and starchy vegetables (most of the time) to avoid insulin-stimulating carbohydrates, all that is left is animal flesh and green vegetables.  That’s just how it is.  We also used to eat almonds—the richest in magnesium, and brazil nuts—the richest in selenium, almost daily.  But because our son was intolerant to both and I was intolerant to brazil nuts, we removed those from our diet as well.

IMG_2275

These were all food intolerances; they were not allergies.  But they were nonetheless intolerances, some stronger, some weaker.  If you are concerned about health in the sense of being in the best state of health you can, then obviously you must not eat foods to which you are intolerant.  Otherwise, your immune system is triggered each time the offending molecules in those foods enter the gut and bloodstream.  This gradually but inevitably makes the intolerance greater, your system weaker, and body sicker.

Over these ten years, I’ve read quite a few books, articles, blog posts, and detailed discussions about health-related matters.  I’ve also experimented quite a bit with my own diet, and learned a great deal from that.  The other thing I’ve done a lot of, is have conversations with people about diet, nutrition, diseases, and the metabolic effects of different foods and of insulin.

My position—which has only grown stronger with time—is that the first and most fundamental pillar of optimal health is having a metabolism that runs on fat.  And this means keeping insulin levels low by restricting sugars and starches.  Not necessarily always, but most of the time, as in almost always.

The first question that people ask when they find out is why: Why do you not eat bread? Bread has forever been essential to humans.  I simply couldn’t live without bread.  Or, why don’t you eat potatoes, or rice, or pasta?  They’re so good!  I simply couldn’t live without potatoes and pasta.  And, you don’t even eat fruit? But isn’t fruit full of vitamins and minerals?

The way I have answered has depended on a lot of things: the setting, the atmosphere, the company, the time available, but most importantly on the person.  Some people are actually interested to find out, and maybe even learn something.  Most, however, are not.  Consequently, I have made the answer shorter and shorter over the years.  Now, I even sometimes say: well, just because, and smile.

Maybe you have wondered, or even still wonder why.  Maybe although you’ve read so many times in my writings that I think everyone seeking to improve their health should restrict insulin-stimulating carbohydrates, you still wonder what the main reason is, what the most fundamental reason for which I don’t eat sugars and starches.  Here’s why:

It’s not primarily because carbs and insulin make us fat by promoting storage and preventing the release of energy from the ever larger reserves of fat in our body: I am lean and always have been.

It’s not primarily because carbs and insulin lead to insulin resistance, metabolic syndrome, and diabetes; inflammation, dyslipidemia, water retention, and high blood pressure; kidney dysfunction, pancreatic dysfunction, and liver dysfunction: my fasting glucose, insulin, and triglycerides have been around 85 mg, 3 milli units, and 40 mg per dl for years; my blood pressure is 110/70 mg Hg, glomerular filtration rate is high, and all pancreatic and liver markers are optimal.

It’s not primarily because carbs and insulin promote cancer growth since cancer cells fuel their activity and rapid reproduction by developing some 10 times the number of insulin receptors as normal cells to capture all the glucose they can, fermenting it without oxygen to produce a little energy and tons of lactic acid, further acidifying the anaerobic environment in which they thrive.  My insulin levels are always low, and my metabolism has been running on fat in a highly oxygenated alkaline environment for a decade.

It’s not primarily because carbs and insulin promote atherosclerosis, heart disease and stroke by triggering hundreds of inflammatory pathways that compound into chronic inflammation and damage to the blood vessels, which then leads to plaque formation and accumulation, restriction of blood flow, and eventually to heart attack and stroke: my sedimentation rate, interleukin-6, C-reactive protein, and Apolipoprotein-A are all very low.

It’s not primarily because carbs and insulin promote the deterioration of the brain, dementia, and Alzheimer’s, both through the damage to blood vessels around and in the brain itself, and insulin resistance of brain cells, which together lead to restricted blood flow, energy and nutrient deficiency, and accumulation of damaging reactive oxygen species and toxins in the cells, and, unsurprisingly, eventually to dysfunction that just grows in time: because my metabolism runs on fat, this means that my brain runs on ketones, and is therefore free of excessive insulin or glucose exposure.

It isn’t primarily for any of these reasons, which, I believe, are each sufficient to motivate avoiding sugars and starches in order to keep tissue exposure to glucose and insulin as low as possible.

My main reason is that, at the cellular level, in its action on the nucleus and on gene expression, insulin is the primary regulator of the rate of ageing.

Insulin is essential for life: without insulin, cells starve and die. It is essential for growth: without insulin cells don’t reproduce, and there can be no growth.  This is why at that most fundamental level, insulin regulate growth in immature individuals.  But in mature individuals, once we have stopped growing, insulin is the primary regulator of the rate of ageing, both in terms of its effect in suppressing the production of antioxidants and cleansing and repair mechanisms within the cell, but also in stimulating cellular reproduction. And the more reproduction cycles, the greater accumulation of DNA transcription defects, the faster the shortening of telomeres, and the faster the ageing.

This is a fundamental fact that appears to be true for all living organisms.  It is as true for yeasts and worms, as it is for mice and rats, as it is for dogs and humans.  And the rate of ageing is the rate of degeneration, of growing dysfunction, of more damage and less repair, of lower metabolic efficiency and less energy, of increased cell death and senescence.  I personally wish to be as healthy, energetic, strong, and sharp as possible for as long as possible.  This is why I personally avoid sugars and starches.  This is why I personally restrict insulin-stimulating carbohydrates.

 

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Want to lose weight? Here’s what you need to know in under 1000 words

One, you don’t want to lose weight: you want to lose fat. You don’t want to lose muscle or bone because they are very important functionally and metabolically. What you want to lose is fat. So weight loss needs to be reworded as fat loss.

Two, roughly speaking, the body is generally either storing surpluses or using reserves.

Three, the major fuels for the body are glucose and fatty acids.

Four, for the body to use fat reserves, insulin levels must be low. Fat cannot be efficiently utilized as long as insulin is high, because insulin promotes storage.

Five, the thyroid gland regulates metabolism and brain function. It requires adequate amounts of iodine without which it cannot work properly. To ensure healthy metabolic function, iodine supplementation is critical.

That’s what you need to know. If you want more details, I can expand a bit.

Insulin regulates fat storage

Every second that we are alive, trillions of biochemical reactions take place. The energy currency is adenosine triphosphate, ATP. Mitochondria produce ATP primarily using glucose or fatty acids. Fatty acids produces a lot more, but glucose is much easier to use. Both are used but one always dominates. In general, if there is glucose to be used, fatty acids are not much. For fat loss, we want to promote fat burning for ATP production to fuel cellular activity.

High glucose levels from carbohydrate intake trigger insulin secretion. This is necessary to bring the glucose into the cell, and to get rid of it from the bloodstream where it causes damage to the tissues by glycation. Within the cell, glucose can be either fermented without oxygen or oxidised with oxygen. Lower oxygen levels (and very high short term metabolic needs) promote fermentation. Higher oxygen levels (and lower metabolic ATP production rates) favour oxidation. More fermentation leads to greater accumulation of lactic acid, which further decreases oxygen levels. Red blood cells do not have mitochondria and therefore can only produce ATP by fermenting glucose.

Lower glucose leads to lower insulin. This triggers the release of fatty acids and glycogen into the bloodstream. If sustained, low glucose leads to the production in the liver of ketones primarily to fuel the brain whose cells can either use glucose, ketones, or medium chain fatty acids because longer molecules cannot pass the blood-brain barrier.

The higher the glucose, the higher the insulin, and the faster the uptake and storage of nutrients from the bloodstream into cells. The lower the glucose, the lower the insulin, and the faster the stored fat can be released and used.

insulinFatStorageFatRelease

Amount of glucose stored as fat and amount of fat released from fat cells as a function of insulin concentration. Plot taken from https://optimisingnutrition.com

The most metabolically active tissue is muscle. The more muscle we have, the more energy is used, and the faster both glucose and fat are burned to supply fuel to the cells. The more we use our muscles, and the more intensely we use them, the more they grow, and the more efficiently they burn both glucose and fat. Also, the stronger the muscles, the stronger and denser the bones will be. This is very important.

Therefore, as we burn more fat, we burn fat more efficiently. As we use our muscles more intensely, we burn more fat. And as we build more and stronger muscle, we burn even more fat even more efficiently, and make the bones stronger.

Different Carbohydrate Intolerance Levels

These mechanisms are universal in animals, but each animal is different, and each person is different. As far as fat loss is concerned, the individuality of people is related to their predispositions to insulin resistance and carbohydrate tolerance, (or actually, intolerance). Every person is differently intolerant to carbohydrates and differently predisposed to insulin resistance.

This is why in a group eating the same diet, there are people who are thin, people who are chubby, people who are fat, and everything in between. Basically, the greater the predisposition to insulin resistance (and the more sedentary), the lower the tolerance to carbohydrates will be, and the fatter you will tend to get. In contrast, the lower the predisposition to insulin resistance (and the more active), the higher the tolerance to carbohydrates, and the thinner you will tend to be.

This translates into different thresholds in the amount of carbohydrate we can eat without negative metabolic consequences, and consequently, the amount under which we must stay in order to burn fat instead of storing it. As a guideline, if you want to burn primarily fat for your body’s energy needs, this threshold would be around 20–25 grams per day if you are fat; around 30–50 gram per day if you are neither fat nor thin, and could be around 80–100 grams per day if you are very thin.

But no matter what your personal threshold happens to be, it will always be the case that the lower the intake of carbohydrates, the lower the glucose and insulin will be, and the more efficiently your body will burn fat as fuel.

Fat Loss Rate

The amount of fat that is burned is determined by the energy balance. The greater the total amount of energy we use, the greater the total energy needs. Total energy needs will mostly be met by energy from food intake and energy from fat reserves. If food energy intake is high, the need for stored energy will be low. If intake is lower, the need for energy from fat reserves will be higher.

Pushing this to the limit—maximal usage of fat stores—we would provide the protein necessary to maintain muscle and other active tissues and nothing more. In this situation, basically all energy needs would be supplied by stored fat reserves and glycogen when needed. This is greatly enhanced by resistance training.

The amount of protein needed is proportional to muscle mass and muscular activity. As a guideline, you can use 1–1.5 grams per kg of lean mass per day in the case of little physical activity, and 2–3 g/kg/d in the case of high muscular activity levels. Excessive protein is not great, but more is almost always better than less.

Fat burning and protein synthesis can be further optimised by intermittent fasting. Extending the time between feedings allows glucose and insulin to drop lower, which increases the rate of fat burning. And by eating fewer but larger amounts of protein in a meal is better because protein synthesis increases in proportion to the amount consumed.

Thyroid function regulates metabolism. Iodine is used in every cell, but in the thyroid, it is concentrated to more than 100 times the average of other tissues, because iodine is the main structural component of thyroid hormones. Iodine supplementation is critical because most soils are highly depleted. It is water soluble and very safe to supplement with.

Summary

  • High insulin from carbohydrate intake promotes fat storage.
  • Low insulin from restricting carbohydrates promotes fat loss.
  • Individual predispositions determine the threshold of carbohydrate tolerance.
  • Below this threshold fat is used as the main source of cellular fuel.
  • The rate of fat loss depends on balance between energy needs and energy intake.
  • Maximal fat loss rates are achieved by supplying just the protein needed to sustain lean tissues.
  • Iodine supplementation is critical to healthy thyroid, metabolic and brain function.

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You have cancer, and there’s lots you can do

Everybody knows that cancer rates are rising everywhere and every year. Everybody also knows that the words, “You have cancer. I am sorry.”, fall upon us like a death sentence. Everybody knows this, because we see it all around us, everywhere we look, and we hear about it every day, everywhere we turn.

If a doctor has, indeed, said these words to us, then we are probably scared, probably very scared. We know that basically everyone we have ever heard of who were diagnosed with cancer, died. Sometimes they died really quickly, like, within a few weeks. Sometimes they died within a few months. Sometimes it wasn’t so quick. Maybe it took a year of two, or three, or even five. They went through rounds of chemo. They were on sick leave at home for months on end. They sometimes appeared to recover at some point, maybe a bit, for a little while, but in the end, they died. And they died of cancer.

We also know that not even the most famous and richest people, like Steve Jobs, for example, can escape this kiss of death that the diagnosis of cancer delivers. Wealth and power are irrelevant when it comes to our prognosis as cancer patients: it is always bad. Of course, how bad it is depends on the kind of cancer, but why is it that so many different people, in so many different places, die of cancer every day?

I won’t venture into formulating an answer to this question, and I won’t dwell on cancer survival statistics. I don’t think it’s useful for us right now. I want to hurry and move to the good news. And the good news is that there many things you can do to help your body rid itself of cancer, which is usually the result of a long-standing disease process that has evolved over a lifetime, and has finally manifested itself in this way. This presentation of the question at hand is definitely not exhaustive, nor attempting to be. But this is what I consider to be some of the essential elements.

whitebloodcellsattackingcancercells

White blood cells (shown in blue) attacking cancer cells (shown in red).

 

Understanding cancer

To understand cancer, we have to understand the origin of cancer cells. Cells become cancerous due to a defect in energy production, a mitochondrial dysfunction, an inability to manufacture enough ATP (adenosine triphosphate) through oxidation of glucose or fatty acids to sustain the cell’s functions. This forces the cell to fall back on anaerobic (without oxygen) fermentation of glucose to supplement the deficient energy production from the dysfunctional or reduced number of mitochondria. Fermentation produces an increase in lactic acid in and around the cell. This decreases the availability of oxygen to the mitochondria, which further impedes their ability to produce ATP through oxidation of nutrients, and creates a negative feedback loop that pushes towards further mitochondrial stress and dysfunction, less oxidation, more fermentation, more acid, and less available oxygen.

Because energy production through fermentation is so very inefficient, the cell needs far more glucose, and naturally develops more insulin receptors in order to be ever more sensitive to, and able to capture circulating glucose more effectively. Cancer cells often have 10 times more insulin receptors than healthy cells. What should be clear is that it doesn’t matter where the cancer is, and it doesn’t matter how it evolved, whether it was due to a gradual evolution from an environment too high in glucose, lacking in oxygen, and saturated with acid, or whether it was due to exposure to a toxin or mitochondrial poison, of which there are many and increasingly more in our environment. In the final analysis, this is how cancer cells become how they are, and this is how they survive.

As to their multiplication and proliferation from a single or small group of microscopic cells to large macroscopic tumours in one spot or all over the place, this can be understood by considering that the cell that is devolving from its normal function to that of cell whose only function is to ferment glucose at the fastest possible rate, loses, little by little, the ability to do whatever it was doing before, by losing the ability to produce ATP that can be used by its different specialised parts and constituents to perform their specialised functions, the cell becomes less and less specialised, less and less differentiated and therefore more and more general and more and more primitive, to the point where the essential ability of the cell to destroy itself, when something in its workings has gone wrong, is lost. Having lost this safeguard, the primitive, the undifferentiated, but also necessarily abnormal and weakened cell, just ferments and multiplies, limited only by its ability to fuel itself and sustain this most basic activity of survival without other purpose but this survival in and of itself.

Removing cancer

Having recognised and understood this, the strategy by which we can help the body rid itself of the cancer cells, and regain its healthy physiological functions becomes clear. We have to 1) do all we can to cut off the source of fuel to the cancer cells, 2) clear out the accumulated acids and transform the acidic environment into one that is alkaline and oxygen-rich, 3) help restore the cells’ mechanism of apoptosis—their ability to self-destruct, and 4) do everything else we can to further weaken and destroy cancer cells by means that simultaneously strengthen healthy cells. It’s a simple strategy that is also simple to put into practice, as we will see in a moment.

1) Starve the cancer cells

The first point is to cut off the fuel to the cancer cells. The source of fuel is glucose, because cancer cells can only ferment and cannot oxidise, and the way the glucose is supplied to the cell is by the action of insulin that moves it across the cell membrane. Therefore, what has to be done to is minimise the availability of glucose, and, more important still, minimise the availability of insulin to shuttle the glucose into the cells. The lower the glucose, the less potential fuel there will be. The lower the insulin, the less glucose will actually be able to enter cells. There is no real lower limit. Without ingesting any carbohydrates, the body maintains and regulates blood sugar according to the stress levels and kinds of activities we engage in, independently of how low insulin levels are. And so, the focus should be to have the lowest possible insulin levels naturally.

The fastest way to lower blood sugar, but especially insulin, is to fast, to stop eating altogether, and just drink water and herbal tea, remembering to eat enough salt to match the water intake. The second best way of doing this is in form very similar, but turns out to be much easier to do, is also a kind of water fasting, but with the addition of fat from coconut oil and butter, melted in the herbal teas. Both of these forms of fasting will most effectively deprive the body of anything that can easily be made into glucose, and of anything that will stimulate the secretion of insulin, thereby will allow glucose to drop as low as possible, but more importantly, insulin to drop and stay at an absolute minimum, and therefore most effectively starving cancer cells, no matter where they are in the body and bodily fluids, in the tissues and organs. The first form of the classic water fast is harder, but many people do it without hesitation nor difficulty. The second form is much easier, and may even be more effective in inducing a deep state of ketosis given the additional intake of medium chain fatty acids.

We can easily imagine doing such a fat “fast” for days, or even weeks, depending on the severity of the situation, our resolve to suffocate and starve the cancer cells as quickly as possible, and, of course, the state and circumstances in which we find ourselves. In addition, we can do this as much as possible on any given day, independently of what else we eat. The more fat and the less carbohydrate we ingest, the lower the insulin and the more effective the anti-cancer healing protocol will be.

The third option is to eat and drink to keep insulin levels as low as possible. Here again, because fat is the macronutrient that stimulates the least secretion of insulin, truly minimal, it should be the main source of calories. Simple carbohydrates and starches are most insulinogenic, and protein is about half as insulinogenic as are carbs. Indigestible fibre does not stimulate insulin. Therefore, in the extreme, we would eat only fat, pure fat. The best ones being the most natural and least processed, most saturated and least unsaturated: coconut fat, butter, animal fat and, the best of the vegetable oils, cold pressed olive oil.

It’s important to understand the difference between having low blood sugar, and having low insulin levels. The first is like the amount of food in the kitchens of the restaurant, the second is like the waiter bringing it to the table. It is far, far more important in our efforts to stop the supply to cancer cells that we keep insulin levels as low as possible, than it is to try to keep glucose levels low. And to push the point further, it doesn’t really matter what the amount of glucose actually is, because as long as insulin is low, it will not be brought into the cell, into the cancer cells. The reason I emphasise this is because lack of sleep, emotional or psychological stress, intense physical exercise will all raise blood sugar levels temporarily, in some instances, to high levels. But as long as insulin is as low as it can be, the sugar will not be readily transported into the cells.

Naturally, we cannot have zero insulin, because we would die: our cells would literally starve to death, no matter how much we ate. Babies with a genetic defect that makes their pancreas not able to produce insulin always died of emancipation before the discovery and subsequent commercialisation of insulin as medicine. Similarly, if at any point in a child’s or adult person’s life, insulin stops being produced, incredible weakness and emancipation will follow, before it is tested and identified as the cause of their problem, hopefully in time before permanent damage ensues. Therefore, there is always some insulin in circulation, and therefore, sugar will eventually make its way into at least some cancer cells. This is why it is important to keep it as low as we possibly can naturally, and this is how we can appreciate the essential difference between the effects of high glucose and high insulin.

In a less extreme form than the fat-fast, we maintain low sugar and low insulin by getting and deriving most of our energy from fat. Eating cucumber or celery with almond butter or tahini, for example, or a green leafy salad with lots of olive oil, walnuts, and avocado, provides basically all calories from the fat, given that cucumber, celery and lettuce greens, are basically just water and indigestible fibre, while almond butter and tahini are 80\% fat by calories, and walnuts are 84\%. So is coconut milk, for example, at nearly 90\%, and dark 85\% chocolate, at 84\% fat based on calories. Focusing on feeding the body with these kinds of healthful, high-fat foods, will nourish, stimulate healing, and keep insulin and glucose levels as low as we can without either water fasting, or consuming only fat.

2) Alkalise to remove and excrete accumulated acids

The second point is just as important as the first, because it is the environment in which the cells live that actually has the most direct effect on their function. We have looked at the importance of achieving and maintaining an alkaline environment in the body in several other places. The essence is excellent hydration with alkaline water (pH>8) combined with the intake of proportional amounts of unrefined salt to promote the release of acids from the tissues, and its excretion through the urine by the kidneys. Without proper hydration, the cells will retain the acid with the little water they have to hold on to. Without proper amounts of salt, the kidneys will also retain the acid in order to maintain the concentration gradient that allows the nephron to function when it re-absorbs water.

Naturally, alkaline water will work infinitely more effectively. But the most important detail is the controlled balance between water and salt intake, and what we want is a lot of water and a lot of salt. We cannot take in large amounts of salt water without getting loose stools. So, it has to be smoothly distributed throughout the day, except in the morning, when we get up, because we are dehydrated, and need to drink about 1 litre of water over the course of one to two hours, before we start taking salt.

If you buy mineral or spring water, find the one that has the highest pH value. It should be greater than at least 8. If you have a water filter at home, then add alkalising drops to it before drinking it. I use Dr. Young’s PuripHy drops.

As acidity decreases, and the environment becomes more alkaline, oxygen will flow more freely, and become more available to mitochondria for oxidising fatty acids in producing energy. Remember that cancer cells do not use oxygen, and cannot use fatty acids to fuel themselves, whereas normal, healthy cells, not only can, but function much more efficiently on fat rather than glucose as their primary fuel. Adding chlorophyll and fresh juice of green vegetables to the alkaline water is an excellent way to further boost alkalisation, neutralisation, and elimination of accumulated metabolic acids. Unlike the first step, which is to lower insulin and glucose levels, and that can be done, to a great extent, literally overnight under fasting conditions, alkalising to eliminate accumulated acids is something that takes time. But in both cases, what matters most is consistency. Hour by hour, and day after day, the body will do what it needs to do as best is can, and improve in these functions with time.

Beyond this fundamental necessity to hydrate with alkaline water throughout the day, and day after day, the most therapeutic way to alkalise the tissues, and detoxify the body, is by taking medicinal baths in which we add two cups of sodium bicarbonate (baking soda), and two cups of magnesium chloride (nigari), or magnesium sulphate (epsom salts), if nigari is not available. This is easy, relaxing, extremely medicinal, and very effective in neutralising and eliminating acids and toxins from the body. In fighting cancer, you should be soaking in this kind of hot bath for 45-60 minutes three times per week. The benefits of this ultra simple trans-dermal therapy with sodium bicarbonate and magnesium are incredible. You can read a lot more about this from the baking soda, magnesium and iodine doctor, Dr Sircus.

3) Restore cellular self-destruct function

The third line of action is also essential, and it only requires you to take a few key supplements. The most important of these in the fight agains cancer is iodine, because of its fundamental role both in the structure and architecture of cells, but also in the regulation of apoptosis, the process by which a damaged cell will self-destruct when things have gone wrong somewhere. The importance of iodine cannot be overemphasised. And in healing cancer, or any serious disease condition, we will want to take high doses daily. Doses of at least 50 mg, but preferably 100 mg.

However, because of its very strong detoxification effects, as it pushes out all accumulated toxic halogens out of the cells to replace these by iodine in its proper place, we must work up to these high doses gradually, starting with 12.5 mg, and increasing the dosage as quickly as possible given the body’s response to it. Some people , maybe most, will experience headaches and possible nausea when starting on iodine. This is perfectly normal. The stronger the reaction, the more indicative of the body’s level of toxicity. Therefore, you should always view this as something good, in that toxins are being excreted out of your cells. It is important to support the detoxification process by taking chlorella and spirulina, probiotics and psyllium husks every day as well, while always drinking a lot of alkaline water with added chlorophyll for extra cleansing, if possible.

What I take and consider to be the best supplement is Iodoral by Optimox. Optimox recommends taking the iodine on an empty stomach for faster absorption, but it can also be taken with food for slower and possibly better assimilation. In addition, although iodine can easily be taken on an empty stomach, the co-factors, which include B vitamins, are much better taken with food to avoid potential nausea or queasiness. Moreover, taking it with food will slow down the absorption, and thereby decrease the negative sensations from the detoxification effects. The only thing is that iodine, given its stimulation of thyroid function, will energise the body. Therefore, it should be taken before midday. I take it either first thing in the morning or at lunch (or both).

You can read about the importance and functions of iodine in the following three books: Iodine, Why You Need It, Why You Can’t Live Without It by Dr. Brownstein; What Doctors Fail to Tell You About Iodine and Your Thyroid by Dr. Thompson; and The iodine crisis: what you don’t know about iodine can wreck your life by L. Farrow. There are also many web resources and highly informative forums about iodine and cancer. You can search for the words iodine and cancer to see for yourself.

Other fundamentally important micronutrients are vitamins B12 and D, both of which are needed for proper cellular function, and DNA transcription and replication, because of their roles in the nucleus of cells, activating and de-activating, switching on and off genes, to ensure everything in the cell works as it should. For best and fastest results—and that’s definitely what we need in our fighting cancer—B12 should be injected weekly in the amount of 1 mg, and in the form of methylcobalamin. (For optimal health in normal circumstances, it can be injected once a month in the amount of 5 mg.) Vitamin D should be taken with its sister vitamins, A and K2, for synergistic effects and biochemical balance in their functions. Each of these have complimentary roles, and should generally be taken together, unless there is a reason not to. You can read these two articles published by Chris Masterjohn from the Weston A. Price Foundation to learn why and how: On the trail of the elusive X-factor: a sixty two year old mystery finally solved, and Update on vitamins A and D.

It is by supporting proper cellular function, especially in the nucleus, with iodine, B12 and D, that cells will regain, little by little, the ability to recognise that they are damaged and need to self-destruct. There will always be millions or even billions of cells involved in the disease process we call cancer, but they will be distributed along a wide spectrum of dysfunction, from having very mildly impaired mitochondrial function from a light oxygen deficit cause by a little too much acid in the environment surrounding the cell, to full cancer cells that derive 100% of their energy needs from anaerobic fermentation without using any oxygen at all, and thriving in extremely acidic conditions.

Hence, many cells will die from being starved of glucose, because that’s the only fuel they can use; many cells will recover enough of their normal regulatory mechanisms to know its time to self-destruct; and many cells will actually regain their healthy function, repair their damaged parts, and replace their dysfunctional mitochondria with new ones. Nothing is ever black and white when it comes to cells and cellular function. Instead, everything is grey. But it is a million different shades of grey.

4) Do everything else that can help

The fact is that there are many, many more things you can do. Many therapies, many treatments, many supplements and herbal formulas, that have all proved highly effective against cancer. There are so many that many books have been written about them: About Raymond Rife, you can read The Cancer Cure That Worked by Barry Lynes; about Gaston Naessens, you can read The Persecution and Trial of Gaston Naessens: The True Story of the Efforts to Suppress an Alternative Treatment for Cancer, AIDS, and Other Immunologically Based Diseases by Christopher Bird; about Rene Caisse and the Essiac tonic, you can read Essiac: The Secrets of Rene Caisse’s Herbal Pharmacy; about Johanna Budwig, you can read Cancer – The Problem and the Solution; and the list goes on. There are websites devoted to these people and their approach to cancer, and this is just a few of them that I know about. One book that compiles a lot, maybe most, of the information on non-toxic treatments for cancer, is Ty Bollinger’s Cancer: Step Outside the Box.

Maybe you find it hard to believe that our governmental and medical authorities would have gone—and continue to this day—to go through such extreme measures in order to suppress treatments that work so effectively to help and heal people of their illnesses and of cancer, without negative side effects, and at very low costs. But this is a simple fact. And it is quite easy to understand if we consider that anyone, or any institution, that has commercial investments and interests in a particular endeavour, will go to great lengths to maintain and strengthen, as much as they can and for as long as they can, the conditions that make them successful. There’s nothing more to it than that. Let’s look at a few of those therapies and supplements which are easy to implement, and highly effective against cancer: hyperthermia, flax seed oil, enzymes, and turmeric.

Hyperthermia, or heat therapy, is a very well studied and effective therapy against cancer, both preventatively and curatively. The idea or principle is very simple: healthy cells can withstand high temperatures without damage. The reason why this is so, and why we know it for sure, is that the body produces fevers as a defence mechanism to destroy invading viruses and bacteria that, unlike our own cells, cannot withstand the heat. Similarly, cancer, and other compromised and damaged cells, are unable to cope with high heat. Hence, it was hypothesised, tested, verified and demonstrated that hyperthermia is really very effective at destroying cancer, while simultaneously cleansing and strengthening healthy cells and tissues. Infrared saunas are ideal in heating the tissues more deeply, but any sauna, steam room, or even bath that induces hyperthermia by raising the temperature in the body, will help kill cancer cells, cleanse, and restore health.

Enzyme therapy has also been used for many decades in the treatment of cancer patients extremely successfully. The late Nicolas Gonzalez who passed away last year, was its most recent champion, following in the footsteps of his mentor, Dr William Kelley. The treatment protocols are more complicated, and are always highly individualised, but the main element is the supplementation with large doses of enzymes, combined with the colon cleansing to eliminate the dead tumour tissues from the body. Large quantities of fresh vegetable juice are also often included in his recommendations. You can read about it here: http://www.dr-gonzalez.com/index.htm, but whether you decide to throw yourself completely into it or not, I strongly recommend taking proteolytic enzymes three times per day, always on an empty stomach at least 30 minutes before eating, and support cleansing by taking a colon cleanser before going to bed. This site, http://www.losethebackpain.com, has good quality enzymes and cleansing supplements that we’ve used, but you can also do your own research.

Flax seed oil, organic and cold pressed, combined with fresh organic quark or cottage cheese is, based on Johanna Budwig’s extensive, lifelong research, as well as practical clinical experience with patients, is another one of the most effective and simple cancer treatments. And although the biochemistry of it, and biochemical pathways through which the cancer is weakened and destroyed may be complicated, the implementation is very easy and simple, costs very little, and cannot in any way bring about harm, unless one is severely allergic to milk proteins (in which case the dairy can be replaced with another source of protein that will work as the carrier). Here is a good article that has links to other excellent articles about this: https://www.cancertutor.com/make_budwig/

Turmeric, an ancient, bright yellow, Indian spice, which is a powder made from drying the ginger-like root that is turmeric, is one of the most researched natural substances in modern times, and is surely one of the most powerful natural anti-cancer supplements. Since it has tons of wide-ranging health benefits, and carries no risks at all, it’s clear that everyone can benefit from it. You can read about it from Mercola here. You should take it three times per day, but with your meals, because the more fat there is in the gut, the better the absorption will be, as is true for most antioxidants, vitamins, and minerals.

I feel it is important to emphasise the point just made about the risk-free nature of supplementing with turmeric, because it is a crucial point that applies to everything we have discussed here, and everything we have discussed in all the natural healing protocols and nutritional approaches we have presented in the past. Food-based nutritional healing is, in general, risk-free, because it doesn’t involve ingestion of or exposure to toxic substances, and instead involves correcting deficiencies, boosting nutritional status, and optimising the biochemical and hormonal environment of the body in order to promote healing.

Of course, we can object by referring to examples of people dying from drinking too much water too quickly. But we are not talking about such extremes. Nonetheless, we could, for example, eat coconut oil or butter all day, and other than the possible nausea from taking in so much fat, you wouldn’t get anything more than loose stools. Moreover, the body’s own hormonal responses would naturally prevent overconsumption through a feeling of extreme satiety that would basically make it impossible to willingly eat more.

Another example is that of using baking soda or iodine. So simple, and yet so powerful, they stand as the perfect examples of the benign nature but extreme effectiveness of natural healing. We find written in the most recent edition of the Manual for the Medical Management of Radiological Casualties of the US Military Medical Operations, Armed Forces Radiobiology Research Institute, that sodium bicarbonate will “prevent deposition of uranium carbonate complexes in the renal tubules”, and that we should, “within 4 hours of exposure, administer potassium iodide (KI) to block uptake of radioactive iodine by the thyroid”, because they are the best known ways to protect the kidneys and thyroid from being destroyed by the radioactive elements that would—without the use of sodium bicarbonate and potassium iodide—migrate to these organs and destroy them.

But why wait for a chemical spill or a nuclear power station meltdown in order to rid the body of accumulated chemicals and toxins, and to replenish every cell with a plentiful supply of iodine to ensure that all cells and all glands function at their best, now and every day? We don’t have to wait. The same goes for turmeric, for enzymes, for B12, for A-D-K2, for hydration, for alkalisation, for minimal glucose and minimal insulin loads, for maximum nutrition and maximum health. Why don’t we start doing this preventatively right now?

Summary and Wrap up

Maybe you know all of this stuff already, or maybe you don’t and you are blown away and overwhelmed by the amount of information and range of topics we have covered. Maybe you are reading this because you are interested and curious to learn and be as well-informed as you can about health topics, or maybe you are desperately looking for relevant information that can help you or a loved one. No matter in which camp you find yourself, here is the summary and wrap up I can offer to bring all of what we have discussed down to a simple set of recommendations that anyone faced with a diagnosis of cancer, and fearful of, or skeptical about, or doubtful that the current standard of care in the cancer industry will help them, can understand and follow, knowing that none of these food choices, supplements, and therapies will bring them harm in any way, and that all will only do good, regardless how dire or hopeless their situation may appear to be.

  • Keep low insulin levels, as low as possible, by not having insulin-stimulating carbohydrates, and by keeping protein intake reasonably low. Focus on consuming natural, unprocessed fats as much as possible to supply the largest proportion of your daily calories. Consider a water or a tea-with-fat fast for a few days when it is suitable, or even as an intermittent fasting strategy on a daily basis. Consider also doing a green juice “fast” (only green vegetables) with added fat from blending in melted coconut oil or milk.
  • Drink alkaline water, always on an empty stomach, considering the day as divided between hydration periods, and feeding and digestion periods. The first hydration period is from the time you get up until you have your first meal. It is good to extend that period if you can to allow plenty of time for proper hydration after a long night of dehydration, with at least 1 to 1.5 litres over a period of at least 2 hours. Drink slowly to improve absorption and not pee everything out. Always allow 30 minutes without drinking before meals, and 2-3 hours after meals, depending on their size. The cycles of hydration and feeding during the day (for 3 meals) should be as follows: drink, wait, eat, wait, drink, wait, eat, wait, drink, wait, eat. For only two meals, which I recommend, then periods of drinking are extended and allow for even better hydration, cleaning of the blood, and better digestion.
  • Take iodine supplements with the co-factors and with food to maximise absorption and effectiveness. Start with 12.5 mg per day, and work your way up to 100 mg. Do this as quickly as your body allows you to. Take the iodine every weekday, and stop on weekends; five days on, two days off. (My wife and I take 50 mg per day.)
  • Take hot baths with sodium bicarbonate and magnesium chloride (or sulphate; 2 cups of each). Soak for 40 to 60 minutes. Do this three times per week. Always take your baths on an empty stomach, and drink at least one litre of alkaline water during the length of the bath. (Once per week is what I aim for as preventative medicine.)
  • Get B12 injections of methylcobalamin, 1 mg on a weekly basis. (My wife and I get a 5 mg injection once per month.)
  • Take proteolytic enzymes and Essiac tonic three times per day, always on an empty stomach, always at least 30 minutes before meals. (We take it once, first thing in the morning.)
  • Take turmeric and turmeric extract, as well as A-D-K2 with every meal or fatty snack, three times per day during recovery. (Once daily in normal circumstances.)
  • Take infrared or regular saunas, every day if possible, or even in the morning and at night if you have or decide to buy your own little sauna. I would definitely do this given how effective hyperthermia is at destroying cancer cells.
  • Eat Budwig cream.
  • Eat and drink greens.
  • Spend time outdoors, as much time as you can, moving, breathing fresh air, exposing your skin to the sunlight.
  • Keep low stress levels, as low as possible. Take tulsi, ashwagandha, and HTP-5 to keep stress hormone levels low, and mood high.
  • Take probiotics, chlorella and spirulina in the morning, and a colon cleansing supplement before bed.
  • Sleep well, long restful nights. Melatonin is very useful for this, and has many additional health benefits.

Cancer is very easy to prevent, but somewhat harder to dislodge once it has taken hold somewhere within the body. But no matter what type of cancer, how localised or generalised it is, or at what stage it finds itself, there is always hope. Hope of getting better and more comfortable, and hope for a complete recovery.

We have to remember that cancer cells are degenerate and weak. By making the environment as health-promoting to normally functioning cells, and simultaneously as hostile as possible to cancer cells, they will perish and be cleared out from the body as the waste that they are. The body heals itself, often miraculously quickly, when impediments are removed, and the elements needed for healing are provided. With all my heart, I hope this can help you and your loved ones.

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Keto-adaptation for optimal physical performance

A young man I know recently started to play rugby at a higher level, and thus more seriously than he ever has in the past. Being a smart guy, he wants to get his nutrition “on point”, as he writes, in order to perform at his best. He started reading about nutrition on the internet, and found it to be like “a snake oil convention”, which it most certainly is. So, he contacted me to get my opinion on the subject. I’ve been meaning to start writing about training and performance for a while, and balance out all my writings about disease and overcoming disease conditions, and so I thought this would be the perfect opportunity to start.

The first thing that needs to be said is that there are common aspects as well as differences in the way training and nutrition should be optimised for different disciplines and goals. In common to all disciplines, are that we always want to perform at our best, and recover as fast as possible. Those are the basic and most fundamental drivers.

Differences are much greater in number and far wider ranging in kind, but they can include core aspects like the duration of the event: speed and power versus endurance and stamina (think of the 100 meter dash versus the marathon, or the velodrome cyclist versus the Tour de France rider); the kind of effort required: sustained versus bursty (think of rowing versus tennis); the medium and nature of the forces against which we are working: water or air, with an intervening machine or without (think of swimming versus jumping towards the rim to slam dunk the basketball, skying versus bobsledding, wrestling or judo versus Formula 1 racing).

In every case, there are preferred and optimal skills and trained reactions, fitness and body composition, as well as morphology and muscular development. For now, let’s just look at the basics in the sense of what every athlete would want and would benefit from no matter what kind of activity they do: best performance and fastest recovery.

The most fundamental point is mitochondrial energy production

At the root of all activity of the body, and at all levels, is the generation of ATP by mitochondria. This is really the bottom line for everything, because this is what cells use to function and do what is required of them in every instant. Mitochondria, small organelles thought to have migrated into a cellular membrane early in the history of evolution of life on the planet, are present in every cell in different amounts, and are essential for life. They can oxidise or burn any macronutrient—glucose, amino acids, or fat—to produce ATP, but the bulk is derived either from glucose or fat. In the process, they produce byproducts of different kinds and in different amounts based on the nature of macronutrient used for fuel, and on the energy demands. Therefore, for optimal performance with a fixed number of mitochondria, we want:

  1. the maximum efficiency in ATP energy production, and
  2. the minimum amount of metabolically taxing byproducts.

These question of deriving the most amount of ATP in the most efficient way with the least amount of byproducts that ultimately impede physiological function, has been considered in On the origin of cancer cells (1 and 2)To summarise in very few words: fatty acids are the most efficient way to store energy, on a gram-per-gram basis they produce the most ATP when oxidised by the mitochondria in an oxygen-rich environment, and their oxidation result in the least amount of acidic and physiologically costly byproducts. Therefore, the inevitable and obvious conclusion, is that for optimal physical performance, we want maximum metabolic efficiency, and for maximum metabolic efficiency, we need to provide the conditions that allow our cells to use fatty acids as their primary source of fuel.

The key is efficient fat utilisation

Efficient fat utilisation is achieved in three stages, which are really just two, because the second and third blend into one another seamlessly. The first step is making sure cells can use fat as fuel. Because insulin signals cells to store energy, it prevents fat utilisation (lipolysis). Inhibiting lipolysis is one of insulin’s main functions. To allow cells to burn fat, insulin must be low. To lower insulin levels, we must either fast, or restrict carbohydrates (and to a lesser extent protein). In fasting conditions, most people will reach insulin levels low enough to start fat-burning after 12 to 16 hours. With severe carbohydrate and protein restriction, that means getting all or almost all of your calories from fat, the timescale is probably similar.This first step is therefore achieved within 24 to 48 hours.

The second step is basic adaptation to deriving cellular energy needs from fatty acids, those that we eat, and those that are stored within the body’s fat cells (adipocytes). This is achieved over the course of about 4 weeks by maintaining a very low carbohydrate, low to moderate protein, and high fat diet.

The third and last step is full keto-adaptation, achieved within two to four months of consistent carbohydrate restriction. The word keto in the term keto-adaptation refers to the fact that, from the breakdown of fats, the liver manufactures ketones, the one we measure as a marker is usually beta-hydroxybutyrate, used primarily to fuel brain cells that can only use glucose and ketones. This stands in contrast to most other cells that can use fatty acids directly. An exception to this—the only one, as far as I know—are red blood cells that can only use glucose.

A point that needs to be appreciated relates to the potency of insulin to stop fat-burning. As soon as glucose spikes, insulin will spike, and will stop fat-burning. This is particularly important if we are aiming to burn as much fat as possible or become as efficient fat-burners as possible. Consequently, the very worst thing we can do is to have sugar in the morning, just before or just after training. Even a small piece of fruit will do it. This will generally always stop fat burning in its tracks. And not just for a few minutes, but for hours, all the hours necessary for insulin levels to drop back down low enough to allow lipolysis to start again.

Maximally efficient fat utilisation is where an athlete wants to be, because this will ensure that they always use as much fat and as little glucose as possible, maximising endurance potential while minimising production and accumulation of lactic acid in the muscles. The most important benefits this brings are to be able to sustain long hours of exercise without “hitting a wall” from the exhaustion of glycogen stores, and having muscle fibres that can function smoothly unimpeded by the presence of large amounts of lactic acid, something which also significantly accelerates recovery, as very little time is needed to clear out the small amounts that remain in the muscle after the event or training session.

Fat stores are, for practical purposes, inexhaustible. Even in very lean athletes (below 10% body fat), there will be between 5 and 10 kg of fat reserves to draw on during that ironman, that ultra-marathon, or that mountain-bike-around-the-clock event. Each gram of these 5-10 kg provides 9 kcal of fuel. And so, that endurance event lasting 12 hours during which you burn 7500 kcal could be fuelled with just 830 g of body fat. Naturally, this would not happen, because glycogen from the liver and the muscles will always be used in greater or lesser amounts depending on the level of stress (physiological and psychological), and intensity of the exercise. Nonetheless, this is a good illustration of the massive reservoir of fuel we have at our disposal if we train the body to utilise fat efficiently.

montBlanc-ultraMarathon

The Mont Blanc ultra-marathon. All long distance runners should be keto-adapted.

To get to this point, the muscle cells need to be trained to use fat, first at very low intensity to make sure that they can fuel the activity using mostly fat, and then gradually increasing the level of intensity to force adaptation in continuing to burn fat as the primary fuel. Best way to achieved this, is by doing low intensity endurance work in a fasted state. And over time, gradually extending duration and increasing intensity.

Moreover, doing intense, muscularly demanding, resistance training in the fasted state, is beneficial in many additional ways, including the secretion of greater amounts of growth hormone and testosterone for better growth and repair of tissues, as well as more effective fat utilisation, and protein recycling, which involves the breakdown of damaged, scarred, and otherwise unused tissues in order to maintain, feed and rebuild the muscle tissues that are being used. The same mechanisms involved in protein recycling, act to preserve muscles that are active, while facilitating the breakdown of other tissues, and in particular fat stores, that are not.

There are many benefits to training in a fasted state, and doing both low intensity endurance, as well as high intensity resistance training. This is especially true over the long term, as the body becomes increasingly more efficient at fat utilisation, increasingly better at preserving active muscle mass, and increasingly more effective in repairing damaged tissues and cleaning out metabolic wastes. Such conditions are naturally highly favourable for building strong, healthy, lean muscle mass.

Fast recovery requires minimising inflammation

Whenever we do anything physical, some level of micro tears, fractures, and injuries to the muscle and bone tissues take place. The body’s repair mechanisms involve an inflammatory response. Without a healthy inflammatory response, we would not be able to recover from injuries, recover from training, or build bone or muscle mass. In fact, we would not be able to survive. What we want, is a fast and effective inflammatory response to heal, repair, or build whatever needs fixing as quickly as possible. What we do not want is a low-level of chronic inflammation that cripples the body from functioning at its best.

One of the greatest advantages of running on a fat-based metabolism with maximally efficient fat utilisation, is the fact that the muscle cells are fuelled by burning fatty acids without producing lactic acid. This is in stark contrast to a glucose-based metabolism, where most of the energy is derived from burning glucose, and this always produces lactic acid. As intensity increases, the amount of lactic acid produced will depend first on the intensity, and second on the level of keto-adaptation. The better the keto-adaptation, the more fat will be used to fuel the cells at higher levels of intensity. But, no matter what, the keto-adapted individual, and the athlete in particular, will always, and in all circumstances, produce less lactic acid than the one running a glucose-fuelled metabolism.

All acidic metabolic waste products need to be eliminated from the body. This is the role of the kidneys, whose function we have explored in The kidney: evolutionary marvel. For lactic acid that accumulates in the muscles, the first stage is to get it out of the muscle, and this usually takes quite a while. It can take from hours up to several days. The process of clearing it out can be accelerated using massage, stretching, and very low intensity exercise. Alkalising baths are a fantastic therapy for accelerating recovery, and lowering inflammation. Magnesium chloride and sodium bicarbonate baths are therefore an absolute must for the serious athlete. We have detailed the importance, roles and functions of magnesium in Why you should start taking magnesium today, and discussed inflammation and the importance of alkalisation in Treating arthritis (1 and 2). 

In the end, all metabolic acids lead to increased inflammation, and, when they accumulate in joints and tendons, inevitably to injury. Insulin-stimulating carbohydrates also cause inflammation. They trigger hundreds of inflammatory pathways. And so, by eliminating them from our diet, and allowing the metabolism to run on fat, we have done as much as we could ever do with our food to minimise inflammation in the body. This is what an athlete wants for the fastest possible recovery time, with best training performance, and the smallest risk of injury.

The final and most important element for fast recovery and low inflammation is optimal hydration. This is the most important because all of the body’s cleaning mechanisms, and especially the function of the kidneys, depend intimately on water and salt. Drink alkaline water on an empty stomach—at least 3.5 litres per day. Eat plenty of salt with all your food—at least a full teaspoon. The more you sweat, the more water, and the more salt you need. We looked in detail at how much of each is optimal in How much salt, how much water, and our amazing kidneys.

When do we eat?

If we train in a fasted state, the best is to train in the first part of the day, taking advantage of the fact that the fast has already lasted 12 hours or so. We can rather easily extend that further, and train around noon, following about 16 hours of fasting. Either way, we will want to eat between one to two hours after training, allowing a good amount of time to make sure the body is well hydrated, and stress levels have dropped. This will bring us to having our first meal of the day somewhere between 12:00 and 15:00. Different people have different schedules and preferences depending on the rhythm of their work and personal life. There are no hard rules, and things have to remain flexible, as irregularity is also an important part of training the body to be more adaptable. In fact, you should be somewhat irregular with your schedule for just this reason.

We can have only one meal per day, or we can have two, or we can have one big meal and some snacks, or, best of all, we can sometimes have one meal, sometimes two meals, sometimes have snacks, and sometimes not. The main point in training the body for optimal metabolic efficiency, is to be a significant amount of time, somewhere between 12 and 20 hours, without eating, and to train in a fasted state, in conditions of low blood sugar and low insulin levels. We discussed intermittent fasting in The crux of intermittent fasting, concluding that one of the most important points for successful and effective intermittent fasting is that the body be fuelled by fat and not by glucose. As you will have gathered by this point, our context here relies on the fact that the body is keto-adapted, and therefore, fuelled by fat.

What do we eat?

That was the original question my friend wanted answered, and it is, in a way, very simple to answer: we eat only the least contaminated, least processed, and least insulinogenic, the most natural, most nutrient dense, and most digestible.

Least contaminated means minimising our body’s exposure to toxic substances, heavy metals, hormone disruptors, pesticides, herbicides, chemical additives, anything that is toxic in one way or another. Least processed means minimising manufactured foods, of which we don’t need any. Least insulinogenic means minimising foods that stimulate the secretion of insulin from the pancreas, and this means minimising intake of simple sugars and starches, and not over-eating protein which is about half as insulinogenic as carbohydrates.

Most natural echoes least contaminated and least processed, but additionally implies a freshness, a wholesomeness, an absence of adulterations and manipulations. That’s what we want. Most nutrient dense means maximising mineral content, vitamin content, optimising amino and fatty acid profiles, and overall micronutrient content for a given amount of calories. Most digestible means minimising digestive stress, maximising enzyme content and nutrient absorption.

Digestion, the function and health of the digestive system, is essential. Everything from the food we eat is made available and usable—or not—by and through the digestive system. We have written about digestion on many occasions, but most specifically in Understanding digestion, Intensive natural healing, and Why we should drink water before meals.

But in practice, what do we eat? No junk of any kind. No polyunsaturated oils. No sweet things. No starches. Excellent animal foods and excellent plant-based foods: grass-fed, full-fat meats and organ meats like liver; nutrient dense and non-toxic fish like sardines, herring, anchovies, seafood and wild fish (avoid tuna, swordfish and any other large predatory fish, because they contain large amounts of mercury and other heavy metals); fatty nuts and seeds, especially coconut products, but also walnuts, macadamia, almonds, hazelnuts; dark leafy greens, both in salads (mixed baby greens, baby spinach, arugula, lamb’s lettuce, lettuces of all kinds) and steamed (chard, spinach, and anything similar); green vegetables like celery, cucumbers, broccoli, asparagus, and string beens; colourful vegetables like purple cabbage, red and yellow peppers. You can eat pretty much anything you can think of that is not processed, nutrient poor, or highly insulinogenic.

What should you have for breakfast? We already solved that problem! You do not eat breakfast anymore, remember?

What do you have for lunch after training? You’re in a rush or just lazy? Well, make yourself a coconut milk smoothy. You can put some protein powder (whey or plant-based, but never soy!), some superfood powders, some hemp or chia seeds. You prefer it sweet-tasting? Put some raspberries or blueberries, and stevia extract. You prefer it green and salty? Put some spinach and salt. In both cases, you can add avocado whenever you want. You can make it with cacao powder, with vanilla extract, or with almond extract. You can add raw or roasted almond or hazelnut butter, sunflower seed butter or tahini. Anything you want that is wholesome and healthful. You’ll need to experiment to find combinations you like. Start simple with few ingredients, and add things bit by bit to keep on top of the process and the blends of flavours.

If you’re not in a rush, or don’t want to have a smoothie? In this case you eat exactly as described above: healthy, nutrient dense animal and plant-based foods. This can be as simple as a can of sardines with a bag of organic baby greens. And for supper, the same as for lunch, really. The same simple and basic principles apply to everything you eat at all times, with these two additional points to keep in mind:

The first is that because we do not eat for a significant part of the day, and also because we eat either just one or two meals, it is crucial to get enough calories and fat, nutrition and protein. Otherwise, we will quickly find ourselves in calorie deficit, and this means that if we keep it up for a long time, we will first burn through our fat reserves, and then burn through our muscles. As athletes, we definitely do not want this. So, it is very important to get all the calories we need, especially if we train a hard or long hours on a daily basis.

The second is that for good, deep and comfortable, restful and restorative sleep, we shouldn’t go to bed on a full stomach, and most importantly, not on a stomach full of protein. Digestion is energy intensive. In the case of protein, it is also highly thermogenic, which means that it generates heat. Therefore, going to bed after a large protein meal will  lead to a restless, tossing, turning, hot and uncomfortable sleep. For a deep and restful sleep, we want the opposite: little digestive activity, a slow heartbeat, and a low body temperature. This means that large protein meals should be had several hours before bedtime, in the afternoon or early evening, allowing a good three to five hours for full digestion before going to bed. If you can’t avoid eating late at night, then eat light: a salad is perfect. For a snack instead of a light meal, have a couple of tablespoons of almond butter on cucumber slices or with celery sticks, for example. Because sleep is really the most important part of the body’s recovery process, it is imperative to optimise sleep.

Closing thoughts

With all of what we have discussed mind, is it really any surprise that more and more professional athletes are opting for this metabolic advantage? A number of years ago, the tennis champion Novak Djokovic divulged one of his secrets. What was it? It was exactly this. This year, the third time winner of the Tour de France, Chris Froome, also divulged one of his secrets. What was it? It was exactly this. Are you curious, say, about Froome’s standard first meal of the day? Four poached eggs, smoked Alaskan salmon, and steamed spinach. Surprising breakfast? Not in the least. Indeed, an excellent breakfast!

We are seeing more and more runners, swimmers, triathletes, but also power lifters and body builders making the switch. It is to their advantage, and when they themselves feel the difference it makes, they know it to be true, at which point there is no turning back. Obviously! Who in their right mind would give up such a metabolic advantage? I suspect that eventually, this will be the standard.

And it’s not surprising at athletes from various disciplines have made these changes to their diets and lifestyles. What is surprising is that so few have actually done this. The change is low, but there is a clear shift in this direction. This is attested by witnessing training specialists promoting these principles, training athletes in this way, and demonstrating the immense advantages that it brings to them in their performances. Vespa Power discussing fat utilisation on their website is a good example.

Is all this stuff new? Of course not! Medical doctors, nutrition researchers , diabetes and metabolic medicine specialists have been talking about this for many decades. Some pioneers include Atkins, Rosedale, Volek and Phinney. And the tradition has continued and expanded, especially in the last decade.

Is this the whole story? Of course not! It never is. But it covers the basics. I plan to explore different aspects of what we started discussing here. You can read more about all these things on blogs and websites. Here are three I have read: the athletic MD Peter Attia had a good blog with many informative articles (especially in the beginning) about physical performance at different stages of his own keto adaptation process. The professional ironman triathlete Ben Greenfield also has written about his experience going form fuelling his body with glucose to using fat instead. I point to these because they have articles specifically about the process of keto adaptation we describe above as foundational for optimal sports performance, and also because they were both meticulous in quantifying the physiological changes and writing about them.

Marty Kendall has a very good blog on optimising nutrition in the sense that we have discussed here, and have been writing about for five years, starting with our very first post, What to eat: four basic rules. But what Marty has done is to actually quantify the value of foods, using the USDA nutritional database, assigning to each food an insulin index derived from its insulinogenic potential, and a nutrient density score based on its macro and micro nutrient content. The associated Facebook group is a great resource for information on this and related topics.

Now that we’ve reached the end, I hope this was useful, and that I have managed to show that, whatever the reason or motivation, whatever the sport or skill set required, there is really no other option other than this when you are serious about optimal physical performance.

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First high-carb-low-fat day after 8 years on a low-carb-high-fat diet

A little taste of what’s to come from the results of my experiment with continuous glucose monitoring: this roller coaster ride is what most people experience every day. What was on the menu: melon, raspberries, watermelon, (nap), coconut water, tomato salad, fresh corn, a little ‘financier aux pistaches’, and finally, popcorn to finish off the day. Can you guess when I ate? Pretty obvious, isn’t it?

Screen Shot 2016-08-07 at 14.43.43

Hypoglycaemia as a metabolic impossibility

Last Thursday, the day before the operation, the dental surgeon told me: “Make sure you have a good breakfast. I don’t want you to get hypoglycaemic. It will last several hours.” I replied: “I never have breakfast, and it is impossible for me to become hypoglycaemic.” He was like: “What? What are you talking about? I don’t understand what you’re saying.” I just said: “Because I don’t eat carbohydrates, I cannot become hypoglycaemic.” I’m not sure he understood what I meant, but I suppose that given my response, he figured I knew what I was talking about.

I’m sure you’ve heard, at one point or another in your life, someone say: “I’m hypoglycaemic, I need to have something”, and then seen them pull out a can or bottle of juice, an apple or an orange, a granola or a chocolate bar? Maybe you’ve said it yourself! It sounds scientific; like we know what we’re talking about. Don’t you think? Maybe we’ve heard a doctor or a nurse say it. Maybe we’ve heard other people say it, here and there. And over time, saying this has become common parlance in North America, and surely in the UK as well. But what does it mean? What do we mean when we say that?

Do you know why I said what I did to the dentist? Do you understand why it is impossible for me, (and possibly you too), to become hypoglycaemic, even without eating for 12, 24, or 36 hours? Why is it that so many people suffer from hypoglycaemia on a daily basis, especially type II diabetics, and all the while, I’m writing that it is ‘a metabolic impossibility’? Am I wrong? Am I lying? Am I confused or trying to be confusing? And why is there so much hype about hypoglycaemia? Just Google it and you’ll see: 6.35 million hits! There’s even a Hypoglycaemic Health Association!

First of all, if you don’t already know what it means, hypo means low, and glycaemia means ‘sugar in the blood’. So, hypoglycaemia just means low blood sugar. But the thing is that what people usually mean when they say this, is that they are feeling tired, slow, flat, low-energy, light headed, maybe even dizzy, and interpret these symptoms to reflect a state of low blood sugar, which it usually does. But there’s a caveat: different people will feel the same symptoms at different blood sugar levels! Isn’t that a little weird? Doesn’t that make you wonder about what this means and implies? If there is such as thing as hypoglycaemia, why would it be different for different people? Meaning, why would a certain blood sugar level be fine for one person, and too low for another?

But what is low blood sugar? What is high blood sugar? What is normal blood sugar? Do you have any idea? And how much sugar is that, actually, circulating in the bloodstream? Any idea about that?

Let’s make it simple. Most people have between 5 and 6 litre of blood. Let’s take 5 litres as our baseline to make the numbers easier. Most people, on average, have around 100 mg/dl of glucose in their blood (even if they should have less!) Since there are 10 dl in 1 litre, and 100 mg =0.1 g, this makes 5*10*0.1 g = 5 g. Think on that for a second: in your entire body, there are 5 litres of blood, and in this volume of blood, there are 5 measly little grams of glucose. That’s a teaspoon!

For very low blood sugar levels, we can go down to about 50 mg/dl (half the normal average). This would amount to just 2.5 g in your whole body! And for critically (as in dangerously) high levels, we can go up to around 400 mg/dl (four times the average). In this case, that would amount to still just 20 g! Therefore, we can say that at any given time in our body there is on average 5 g of sugar, very rarely less than 2.5 g, and only extremely rarely, when we are severely diabetic, up to 20 g. So, all things considered, it’s not much, is it?

Now, why is it that most people feel hypoglycaemic at one point or another if they don’t eat for a while, sometimes in as little as a few hours? Why would different people feel these symptoms more or less intensely? And why would different people feel the same unpleasant or even debilitating symptoms of hypoglycaemia at different concentrations of blood glucose?

Well, if you feel symptoms of hypoglycaemia it means that 1) your blood glucose levels are significantly lower than your own usual average level, the level at which your system and cells have gotten used to functioning. This average level could be 200, 150, 120, 100 mg/dl or whatever. And the lower threshold before you start feeling weak, tired or even dizzy could be 40, 50, 60, or even 90 mg/dl. In fact, diabetics or soon-to-be-diabetics, could be walking around, going about their business with an average of 150, 200 or even 300 mg/dl without knowing it, until they get a blood test and someone notices. And they would definitely feel hypoglycaemic at levels that could be quite high. How come?

The key to understanding this conundrum in the apparent subjectivity of hypoglycaemia is the notion of glucose tolerance. But what is glucose tolerance if it is not insulin sensitivity? And what is insulin sensitivity if it is not the flip side of insulin resistance? I hope that by now, having been reading this blog for a while, you know everything about insulin resistance, how it develops and how it manifests itself in the biochemistry and metabolic functions of the body. (If you don’t, then just reread the posts you’ll find in the Diabetes and Carbs categories.)

This notion of tolerance explains it all very neatly: with chronic exposure to glucose, (as in high average levels of glucose in the blood for an extended time), insulin resistance increases, and thus, insulin sensitivity decreases. As insulin sensitivity decreases, more insulin is needed to clear the glucose from the bloodstream, and more glucose stays in circulation longer. The cells get used to this high level of insulin, and become less and less sensitive to it, allowing less and less glucose to get in. When the level of glucose drops below the threshold at which the cells can use it without much effort, muscle but especially brain cells, we feel hypoglycaemic. This is why hypoglycaemia is defined on a subjective and relative scale that depends on our own cells’ sensitivity to insulin, the hormone that shuttles the glucose in. We become hypoglycaemic when the body cannot use fat to fuel its cells, and ketones to fuel its brain. And the more insulin resistant, the more prone to hypoglycaemia.

Moreover, insulin sensitivity, or resistance, exists on a continuous spectrum in the population. It goes from extreme sensitivity to extreme resistance. On the side of high resistance, we have type II diabetics; and on the side of high sensitivity, we have those people like me, and maybe also like you, who restrict carbohydrates, getting most of their calories from fat, and whose cells are consequently fuelled primarily by fat and not by glucose. This makes them, it makes us, not only highly metabolically efficient, but also impervious to hypoglycaemia.

This is why I said what I did to my dentist over the phone the other day: for a body whose cells are highly insulin sensitive from being minimally exposed to glucose/insulin in the bloodstream, the levels of which are delicately and sensitively regulated by the liver (glucose) and pancreas (insulin) throughout the day based on food intake, activity and stress levels, the cells are primed to burn fat efficiently, and the liver is primed to produce all the fat-derived ketones to nourish the brain, which they do far better than glucose can. For a body that works like that, it is physiologically impossible to become hypoglycaemic.

By the same token, it is also physiologically impossible to ‘hit the wall’, just because the cells are fuelled by burning fat, not glucose, and there is always a large reservoir of fat in the body, in terms of calories, at least an order of magnitude larger than the reserves of glycogen in the liver and muscles combined, and this, no matter how thin you may be. For example, even at 8% body fat (like me), which is quite low, a person weighing 63 kg (like me), has 5 kg of fat to draw on, providing a reservoir of 45 000 kcal! This is why we see more and more high level long distance athletes and professionals (like this one), and even power lifters (like this one) switching to a very low carb high fat diet (often abbreviated VLCHF). They do this to get lean and to tap into the metabolic advantages of nutritional ketosis.

Two final points:

1) Insulin sensitivity depends sensitively on exposure to insulin, which depends sensitively on the presence of glucose, which depends sensitively on carbohydrate intake. And it is as simple as this: the less carbohydrate, the less glucose; the less glucose, the less insulin; the less insulin, the more insulin-sensitive. This is always true even if different people have different genetic predispositions to insulin resistance.

2) Nutritional ketosis depends on the ratio of calories derived from fat to those derived from carbs, as well as on a specific maximum amount of insulin-stimulating carbohydrates per day. This threshold depends on each person individually. For one person it can be as high as 100-120 g, whereas for another it could be at low as 15-20 g. In addition, if you deplete your glycogen stores from going for a really long bike ride, for example, you can eat as much as 200 or even 300 g of carbs, and still remain in ketosis, because all of it will go to replete glycogen in the muscles and liver. In most people and in most cases, however, a standard guideline is less than 50 g per day. But, remember, the lower the better.

So, are you clear on what the deal is with hypoglycaemia? And now, what’s it gonna be: carbs, hypoglycaemia, feeling tired and irritable, low in energy and mentally slow, light headed and dizzy; or fats and protein, nutritional ketosis, feeling good and strong, high in energy and mentally sharp, stable and alert.  That’s a no-brainer, right? What do you say?

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Living healthy to 160 – insulin and the genetics of longevity

Of the most remarkable discoveries of the last 15 years, discoveries that might well turn out to be the most remarkable of the 21st century, are those of the telomere—a little tail at the end of our DNA whose length tells us how long we have left to live, and of the enzyme telomerase—the specialised protein whose job it is to try to repair the telomeres so that the cells (and we) can live longer and, from an evolutionary perspective, increase the probability that we’ll have more babies. This and other research into the biology of ageing and the details relating to the transcription of DNA, and the expression or suppression of genes is truly amazingly fascinating. I will turn to this in time, but think it would be jumping the gun to do so now.

What is definitely one of the most remarkable discoveries of the 20th century pertains to the hormone insulin. I am not, however, here referring to the fact that its discovery revolutionised medicine by allowing the saving of countless diabetics from highly premature and painful deaths, usually preceded by torturous amputations of their feet or legs and all the of the horror and misery brought on by these seemingly barbaric and radically extreme measures. (And don’t for one second imagine that such amputations are a thing of the past: I know for a fact—heard directly from the mouth of a practicing orthopaedic surgeon—that amputations are the reality of his everyday, performing sometimes two in a single day.) I’m not either, at least this time, talking about insulin as the master metabolic hormone that regulates the storage into cells of nutrients circulating in the bloodstream. What I am referring to as one of the 20th century’s greatest discoveries in regards to insulin is that of its role in regulating the rate of ageing.

Something that is almost as remarkable is that we hardly ever hear or read about this. For me, that’s really strange. But whatever, I’m not going to hypothesise and speculate to come up with an explanation for why this is. Insulin as regulator of the rate of ageing is what we’ll look at in this article.

Why do mice live two years but bats fifty? Why do rats live three years, but squirrels fifteen. Why do some tortoises live hundreds of year? Why do the smallest dogs, like Chihuahuas, live about twenty years, while the largest, like Great Danes, live five to seven years only? And why do we, humans, live around 80 years, rarely making it to 90, and very rarely to 100 years of age? It is this line of questioning that triggered in the late 80’s and early 90’s a geneticist working in evolutionary biology to hypothesise, for the first time, that ageing could be genetically regulated, at least to a certain extent.

It was the discovery and subsequent realisation in evolutionary biology at that time, that a large number of fundamental cellular processes and mechanisms regulated by a variety of genetic expressions were common to widely different organisms. The realisation was that because all animal life must necessarily share a common ancestor, it is not only logical that the most fundamental functions of cells and especially of how genes express themselves under the influence of hormones essential for life could be the same, but that it should be, to a great extent, expected to be that way. And even though these considerations may seem obvious in retrospect, the fact is that there was only one person with this knowledge, asking these questions, and having the means to do something about seeking an answer to some. Cynthia Kenyon, Professor at UCSF, was this person.

The subject was quick to choose: the tine worm that Kenyon had already been studying for years, C. elegans, was perfect because it is simple but nonetheless a complex animal, and because it has a short natural lifespan of about 30 days. The first step was clearly defined: find at least one long-lived individual. What seems very surprising from our current vantage point it that she couldn’t readily find one: she couldn’t convince anyone to join with her in this endeavour. Everyone was at that time convinced that ageing was something that just happened: things just wore out and deteriorated with use and with time; nothing to do with genes. But how could this be if different species—some very physically similar—are witnessed to have such widely different lifespans? It just had to be genetic at some level, Kenyon thought. Eventually, after a few years of asking around and searching, she found a young PhD student that was up to it, and set out to find a long-lived mutant.

A number of months down the road a long-lived mutant was found and immediately identified as a ‘DAF-2 mutant’. This mutation made the DAF-2 gene—a gene responsible for the function of two kinds of hormone receptors on a cell’s membrane—less active. The next step was to artificially create a population of DAF-2 mutants and see how long they live, statistically speaking, compared to normal C. elegans. It was found that the genetically ‘damaged’ worms, the ones for which they had turned down the expression of the DAF-2 gene, lived twice as long: starting with exactly the same number of worms, it took 70 days for the last one of the mutants to die compared to 30 days in the normal population.

But an additional observation was made: the curve that traced the fraction of worms remaining was stretched by a factor of two from about the start of adulthood for the mutants. They had the same relatively short childhood but then for the remainder of their lives, for every day in the life of the normal worms, the mutants would live two days. The most impressive was that they were really half their chronologically equally aged cousins in all respects: external appearance, level of activity and reproduction.

To make your appreciate this point as much as you should, this observation with respect to not just the lifespan but notably the healthspan of C. elegans would translate in human terms in someone being 80 years old but looking and acting like a 40 year old in the sense that nobody could tell that they were not 40, let alone 80 years old. Just like Aragon in the The Lord of the Rings. This person would be like a 40 year old at 80, like a 60 year old at 120, and like an 80 year old person coming to the end of their life by the time they were 160! Can you even imagine that? Hard isn’t it. But this is exactly what Kenyon and her team were looking at in these experiments with these little worms.

Now they wanted to understand the effect of the DAF-2 gene, or rather, understand the effect of suppressing its expression in the DNA of each cell’s nucleus at different developmental stages. If it was turned off completely, the worms would die: clearly, DAF-2 expression, at least in C. elegans, is essential for life. If it was suppressed immediately after birth (hatching), the little worms would enter the Dauer state in which they don’t eat, don’t grow, don’t reproduce, and basically don’t move either: they just sit and wait. Wait for what? For better times!

This Dauer state is a remarkable evolutionary adaptation seem in some species that allows the individual to survive during periods of severe environmental stress such as lack of food or water, but also high UV radiation or chemical exposure, for example, for long periods of time with respect to their normal lifespan in a very efficient kind of metabolic, physiological and reproductive hibernation. What’s really cool is that inducing worms out of the Dauer state, no matter how long they’ve been in it, they begin to live normally again, moving and eating, but also reproducing. So, in the Dauer state C. elegans literally stops ageing altogether and waits, suspending metabolic activities and physiological functions until conditions for reproduction and life become adequate once again.

celegansfasting

Taken from Worms live longer when they stop eating  (http://www.bbc.co.uk/nature/2790633)

If DAF-2 expression was turned back up to normal, then they moved out of Dauer and resumed their development stages equivalent to childhood, teenage-hood, and then adulthood, but didn’t live any longer as adults. Finally, suppressing DAF-2 expression at the onset of adulthood resulted in the extended lifespan as originally observed. The conclusion was therefore clear: DAF-2 expression is essential for life and necessary for normal and healthy growth and development in immature individuals from birth until they reach maturity, and suppressing DAF-2 expression was only effective at extending both lifespan and healthspan in mature individuals.Going further, they now wanted to understand how DAF-2 suppression actually worked to extent healthspan: what were the actual mechanisms that made the worms live longer when DAF-2 expression was turned down. For this, Kenyon’s team needed to look at all of C. elegans’s 20000 genes and figure out how they affect each other. (Note that this is also more or less how many genes we have, but C. elegans has only 3 chromosomes and is also hermaphrodite.) The sequencing of the worm’s genome was done in 1998, and what was found after analysis was very interesting:

The DAF-2 gene activate a phosphorylation chain that attaches phosphate groups onto the DAF-16 transcription factor. In normal individuals the DAF-2 gene is expressed normally, the phosphorylation chain works unimpeded, and the DAF-16 transcription factor is inactivated. In the mutants, the DAF-2 gene expression is suppressed, and as a consequence, the DAF-16 transcription factor is not inactivated and instead accumulates in the nucleus. There, DAF-16 encodes what Kenyon’s team showed to be the genetic key to health and longevity they were looking for from the start of this now decade long pursuit: the FOXO gene.

What does FOXO do? It promotes the expression of other genes, at least four other genes: one responsible for manufacturing antioxidants to neutralise free radicals the largest amount of which are produced by the mitochondria as they make energy for the cell, a second responsible for manufacturing ‘chaperons’ whose role as specialised proteins is to transport other proteins and in particular to bring damaged ones to the cell’s garbage collector and recycling facility to promote the replacement of those damaged proteins by new and well-functioning ones; a third responsible for manufacturing antimicrobial molecules that increase the cell’s resistance to bacterial and viral invaders; and the fourth that improves metabolic functions and in particular fat transport (reduce) and utilisation (increase).

It is these four genetically regulated cellular protection and repair mechanisms, the cumulative combined effects of all these increased expressions of antioxidants, chaperons, antimicrobials and metabolic efficiency—all of them at the cellular level—that allow the lucky DAF-2 suppressed mutants to live twice as long twice as healthy. Remarkable!

Now that all the cards about how the long-lived mutants actually live twice as long as expected under normal conditions are laid on the table, and that there is only one detail I left out of the story up to this point, tell me: can you guess what are the two sister hormones to which the cell’s sensitivity through the activity of its receptors for them are controlled by the DAF-2 gene? It’s a trick question because I told you half the answer in the introduction: The DAF-2 gene encodes the hormone receptors for both insulin and the primary form of insuline-like growth factor IGF-1. Surprised? It isn’t surprising, really. In fact, it all makes perfect sense:

Insulin and IGF-1 promote growth; nutrient absorption and cellular growth and reproduction are essential for life and thus common to all living organisms, including the more primitive of them like yeasts; growth in immature individuals is fundamental for health and for ensuring they reach maturity; but growth in adults, in mature individuals, just means ageing, and the more insulin and IGF-1 there is, the faster the rate of cellular damage and deterioration, the more genetic mutations from errors in transcription, the more pronounced the deterioration of the brain and the heart, of the arteries and the veins, of the muscles, the bones and the joints, and obviously, the faster the rate of ageing. Because what is ageing if it is not the word we use to describe the sum total, the multiple negative consequences, the end result of all of these deteriorations in these vital organs and systems but also everywhere else throughout the organism, all of it starting at the cellular level, in the nucleus of every cell.

About the necessity of insulin for normal growth, you should definitely not think that these observations impliy we should stimulate insulin secretion in the young in order to ensure proper growth. Totally not! The body knows exactly when and how much insulin is needed at any given time. In fact, any additional stimulation of insulin promoted by eating simple and starchy carbs actually deregulates the proper balance of hormones that the body is trying to maintain. This deregulation from a sugar laden diet in children is the very reason for many wide spread health problems in our youth most important of which is childhood obesity and the metabolic and physiological stresses this brings on. So, leave it to mother nature to know how to regulate the concentration of insulin in the bloodstream. Do not disrupt the delicate biochemical balance by ingesting refined carbohydrates: it’s the last thing anyone needs for good health and long life.

The first results were so interesting that several other groups joined in this research into the genetics of ageing. Not as much as one would think, but at least a handful of other groups began to apply and expand the techniques to other species. Unsurprisingly, the same effects, although with different magnitudes, were seen in these very different species, from an evolutionary standpoint: fruit flies and mice. In addition, the connection was made with lifespan-extending experiments using calorie-restriction, which have also been carried out on mice and other animals (we’ll look into this another time). And beyond the work around DAF-2, DAF-16 and FOXO, Kenyon’s group investigated other ways to influence lifespan and found two more.

The first was by disabling some of the little worm’s sensory neurones of which there are very few, making it easy to test and determine the influence they have separately and in combinations. They tested smell and taste neurones, found that disabling some would extend lifespan while disabling others didn’t. They also found that disabling different combinations of smell and taste neurones could have nulling effects. The second was playing with the TOR gene expression. For now, however, we will leave it at that.

As the fact that it is rare and relatively hard to come by this work without actually looking for it, there is something else I find very hard to comprehend. In Kenyon’s various lectures on this work, there is usually a mention of the biotech company she founded called Elixir Pharmaceuticals and how they aim to find one or more drugs that can suppress DAF-2 expression in humans without causing negative side-effects in order to extend lifespan and healthspan as was done in C. elegans with genetic manipulation. That’s fine, and does make sense to a certain extent, especially if we can find not chemical drugs but natural plant-derived compounds that have this effect on us.

The thing that doesn’t make sense and that is hard to understand from the naive perspective of the honest scientist looking for the simplest possible solution to a problem of inferring something we don’t know from information that relates to what we want to know: in this case this mean the simplest way to make the best use of this information and apply what we have learnt from these two and half decades of research in a way that we know would be beneficial in promoting a longer and healthier lifespan in humans without risks through the introduction of foreign substances in our body. Because they haven’t, here I offer my attempt to do this.

We have, thanks to Kenyon and others, understood in great detail how lifespan in complex organisms can be, to a great extent, genetically regulated, and which genes, transcription factors and mechanisms are involved in the process of regulating the rate of ageing in conjunction with the propensity for developing age-related degenerative diseases. In the final analysis, the main players are the DAF-2 gene that tunes up or down the sensitivity of insulin and IGF-1 receptors, the DAF-16 transcription factor that encodes the FOXO gene but is made inactive by the expression of DAF-2, and the star FOXO longevity gene that promotes the expression other genes responsible for stimulating the cell’s most powerful protection and repair mechanisms.

We have, from many decades of research on calorie-restriction and fasting in animals including humans (and which we’ll explore elsewhere), understood that this is an extremely effective way to extent both lifespan and healthspan and basically eliminate the occurrence of age-related degenerative diseases by greatly increase resistance to health disorders of all kinds. Some key observations on calorie-restricted animals include their very low blood levels of sugar, insulin and IGF-1, high metabolic efficiency and ability to utilise fat demonstrated by low blood levels of triglycerides, and their remarkably younger appearance with increased energy and activity levels.

And finally, we have, from more than a century of observations and research, concluded that diabetics, whose condition is characterised by very high levels of blood glucose, insulin and triglycerides, are plagued by a several-fold increase in rates of cancer, stroke, heart disease, kidney disease, arthritis, Alzheimer’s and dementia, basically all the age-related degenerative diseases known to us, and in addition, also a several fold increase in their rate of ageing based on the spectrum of blood markers used for this purpose, their appearance, but also on the length of their telomeres.

Is it not, therefore, obvious from these observations that high blood sugar, high insulin and high triglycerides are hallmarks of accelerated ageing and a propensity for degenerative diseases, while low blood sugar, low insulin and low triglycerides are instead necessarily related to extended lifespan, extended healthspan and increased resistance to all disease conditions including those categorised as degenerative, and this, independently of the actual mechanisms involved?

Is it not, therefore, plausible from these observations that the genetic mechanisms relating to the function of the DAF-2 gene, DAF-16 transcription factor and FOXO gene in conferring to the DAF-2 mutants twice as long a life can, in fact, be activated and enhanced epigenetically by creating an environment in the organism that is conducive to it: simply by keeping blood sugar, insulin and triglycerides as low as possible? In other words, isn’t it plausible from these observations that by manipulating the biochemistry to ensure that blood sugar, insulin and triglycerides are throughout the day and night as low as possible depending on the organisms requirements, that this will actually translate into the activation of the FOXO gene to enhance protection and repair at the cellular level and thus extend lifespan and healthspan?

And what is, not only the easiest and simplest, but also the most effective way to do this? It is to eliminate insulin-stimulating carbohydrates—sugars and starches—from the diet completely. This, within 24-48 hours, will allow sugar levels to drop to a functional minimum. The low blood sugar will allow the pancreas to reduce production and insulin levels to drop bit by bit. Lowered insulin will eventually allow the cells to start using the fat circulating in the blood, and in time, increase in efficiency, thereby dropping triglyceride levels lower and lower.

Why is it you think that Kenyon never mentions this anywhere? Do you think that this has simply not occurred to her? I honestly don’t know. But if there is a single thing to remember it is this: insulin is necessary for life; in the immature individual, insulin regulates growth; in the mature individual, insulin regulates the rate of ageing and the propensity for degenerative diseases. Hence, if you are a mature individual, and by this I mean full grown, and if you want to live long and healthy, the very first thing you need to do is to keep the concentration of insulin circulating in your blood as low as possible. Everything else that we can do to extend healthspan and lifespan is secondary to this.

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Reversing diabetes: a four-week programme

The key factors of the process of reversing diabetes are: dropping blood sugar concentration and keeping it low, dropping insulin concentration and keeping it low, and alkalising the blood, fluids, tissues and organs—especially the pancreas, to eliminate accumulated acids and reverse the physiologically debilitating effects of chronic acidosis so common to diabetes.

We have examined both the process of developing and that of reversing diabetes in several previous articles. Now, we present a detailed four-week programme to put things into practice, begin recovering correct metabolic function, and get you on your way to ridding yourself of diabetes, if this happens to be a condition from which you are already suffering, towards which you are moving, or simply want to make sure it never develops.

As you will see, beyond the manipulation of the biochemistry through what is consumed, there are in addition several tweaks that are employed to ensure the best possible response to and outcome of the programme. These have mostly to do with timing: when we do things, when we drink, and when we eat. But also include important supplements (in addition to other ones you are taking like B12, ubiquinol, etc); as well as physical exercise, and specific types of exercise done under specific conditions.

The programme is constructed based on a four-week period because this is the amount of time that is needed, in the majority of cases, for the hormonal system to rebalance itself around the much lowered insulin levels, and for the cells and metabolism to regain insulin sensitivity and switch from using glucose and breaking down muscle tissue to satisfy energy needs, to instead use primarily fat, and naturally, as we would expect, the fat stored in the body’s adipose tissues throughout, which means sub-cutaneous—the fat that sits under the skin, intra-abdominal—the fat that is between the various digestive organs in the abdomen, and even the fat that is stored inside the tissues of organs like the liver and heart, and in the muscles themselves.

It is very important to understand, however, that even though the startup programme lasts four weeks, it is a transition period and a complete re-education that marks the beginning of a different way of doing things in order to first allow the body to heal itself and for you to regain your health, and then to maintain and refine this state of health over the course of the rest of your life.

It is also very important to understand that what leads and has led you to a diabetic or pre-diabetic condition are factors related primarily to diet and lifestyle, which if adopted by most will cause similar metabolic dysfunction, and obviously, if adopted anew following this four week programme will inevitably lead back to diabetes, and all that much faster for those whose system has already been compromised by the years and decades that led to this metabolic dysfunction in the first place.

Therefore, you must absolutely understand that this is a four-week programme intended to correct major imbalances and dysfunction and get you on your way to reversing your diabetes and tuning your metabolism to efficiently run on fats as the primary cellular fuel. But that it is also intended to re-educate and teach you a completely new way of doing things on a daily basis in order to empower you in knowing what to do to be and remain in perfect health, why you do what you do, and why it works on a physiological and biochemical level.

Lastly, because of its strict timing and numerous elements throughout the day on a very regular schedule, you have to make this programme a priority, and, ideally, make it your primary activity during this period. You will probably find it close to impossible to follow if you are trying to maintain other demanding and time consuming activities like a full time job at the same time. So, just take a break from everything else, and concentrate on your health for a month. Afterwards, once many of these new ways of taking care of yourself have become more habitual, you will find it far easier to maintain a similar routine while working and doing other things simply because it will be far more natural for you.

The first five days

Background

For maximal effectiveness, we start with a period of intensive cleansing and alkalisation during which the key nutritional element is fresh juice of green vegetables, and the sources of calories are restricted to coconut oil, coconut milk, coconut flesh and milled chia seeds. Like a traditional juice cleanse, everything that is consumed is raw and therefore living, enzyme rich, and easily absorbed with minimal digestive stress; and nothing is acid-forming and acidifying, for this would defeat one of the fundamental purposes of the healing protocol which is essential to restore correct pancreatic function.

Highly unlike a traditional juice cleanse, however, there are virtually no simple sugars consumed and entering the bloodstream, and there is a significant amount of fat, almost all derived from coconut oil. This serves several purposes: it provides the metabolism a perfect fuel for cellular function that is easily broken down and generally not stocked away in fat cells; it enhances the production of ketone bodies necessary to fuel the brain in the absence of glucose, at the same time helping heal and repair the brain by promoting the evacuation of plaques from cerebral arteries and thus increasing blood flow to these starved brain cells; it maximises the absorption of the rich array of minerals, antioxidants and phytonutrients in the green juices; and finally, but also importantly, it very effectively suppresses hunger.

During this period the body will quickly and efficiently make the metabolic transition from using exclusively glucose as is always the case in diabetics and insulin resistant individuals, to burning fat reserves as the cellular fuel of choice; significantly decrease the level of systemic inflammation and release several kilograms of the water that is retained under conditions of chronic inflammation and insulin resistance, in great part responsible for hypertension, swelling of the joints and extremities, and poor blood circulation; thoroughly alkalise, cleanse and begin to rejuvenate, heal and repair the vital digestive organs: the stomach and intestines, and the kidneys, pancreas and liver; alkalise the blood and eliminate large amounts of accumulated acids stored throughout the body in the joints, soft tissues and muscles.

All of these processes are very physiologically tiring. For this reason it is important to rest in the afternoon, and have long nights of deep sleep every night. Hence, only walking is recommended as a form of exercise during this period, ideally in the morning (between 9:00 and 10:00) and in the evening after the last meal (anywhere between 20:00 and 22:00).

Detailed schedule

Here is what and when to eat and drink during this period (times can be adjusted slightly according to sleep patterns):

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of plain water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3; Baseline Nutritionals)
    • Spirulina (3; Nutrex) / Chlorella (5; Healthforce Nutritionals)
    • Tulsi extract
    • Lugol’s iodine solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors (Optimox)
    • Probiotics (Prescript-Assist)

9:30-10:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tablespoon, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

11:30-12:00 – Lemonade

  • Lemonade: 1 medium (or 2 small) pressed lemon, 1/2 tsp salt, 2 mini spoon stevia in 500 ml of water.
  • Vitamin C: 1/2 tsp with small amount of water, stir until fizzing stops, fill small glass half way. (Ultimate Ascorbate C Powder by Source Naturals mixed with highest quality, food grade, powdered sodium bicarbonate in ratio 2:1)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi
    • Lugol’s
    • ATP Cofactors

13:00-13:30 – Green juice and coconut milk pudding/ice cream

  • Green juice without coconut oil
  • Coconut milk pudding (blueberry, raspberry, blackberry or cacao-chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))
    • Krill Oil (2)
    • Astaxanthin
    • A/D/K2
    • Zinc

14:00-15:30 – Sleep

Sleep (very important for the first 5 days that will be very tiring for the body in terms of cleansing and repair)

16:00-16:30 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics

16:30-17:00 – Green juice and chia seeds

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs melted)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

18:00-18:30 – Lemonade

Lemonade and Vitamin C (as above)

19:00-19:30 – Salty veggies

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)

20:00-20:30 – Green juice and coconut macaroons

  • Green juice without coconut oil and coconut macaroons (but not with cacao).
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed) – Psyllium and charcoal

  • Large glass of water with psyllium husks (2 rounded teaspoons, mixed and allowed to swell for a few minutes)
  • Supplements:
    • Charcoal (Source Naturals)
    • Valerian root extract (Bluebonnet Nutrition)
    • NightRest (Source Naturals)

Beyond the first five days

Background

At this stage, the body will have undergone a radical transformation biochemically and physiologically from the inside out. Most noticeable will be the loss at least 4-6 kilos of water (about 2 kg) and fat (about 2-4 kg), with the accompanying feeling of being much lighter and thinner at the waste with a deflated abdomen and gut. The digestive system will have experienced a very effective cleansing and bowel movements will be noticeably more regular and quite different in texture, smell and sensation. The smell and volume of both urine and sweat will have evolved markedly during this period. And all the vital digestive organs will have been given a powerful boost and rejuvenation, but this cannot really be felt. You should as mindful as possible of all of these details and everything else you can notice over the course of the first five days. This will give you a much deeper appreciation of the process and of its importance in regards to your moving towards better health.

We can now continue with a regime that includes two green juices per day instead of four, dropping the afternoon green juice, and replacing the evening green juice by a large green leafy salad with small amounts of nuts, seeds or fish (sardines, anchovies or wild smoked salmon, for example). We will also reduce quantity and frequency of supplements.

In addition, we will introduce a component of exercise that is absent in the first five days, which will greatly enhance the body’s response to the new regime and metabolic environment. The exercise will take the form of fast walking with very light weights for strengthening the shoulders and arms, Pilates workouts to develop strength in the core muscles (abs and back) for postural balance, high intensity interval training coupled with resistance as well as cross-fit training with weights to increase cardiovascular and metabolic efficiency, fat and glucose utilisation, muscle mass, done density, and tendon and ligament strength and flexibility.

Detailed schedule

8:00-9:00 (or upon getting out of bed) – Water and Mg oil

  • Put on Mg oil all over the legs, arms, chest and abdomen, neck, shoulders and back (as best you can). Leave on for at least 30 minutes before showering.
  • Large glass of water (400-500 ml)
  • Supplements:
    • Proteolytic enzyme complex (3)
    • Spirulina (3) / Chlorella (5)
    • Tulsi extract
    • Lugol’s solution (in water; 5%: 6 drops, 15%: 2 drops)
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract
    • Probiotics

9:00-9:45 – Walk

Fast walk with 1 kg weights in each hand, using them to do shoulder rotations, biceps curls and triceps extensions while walking.

10:00 – Green juice

  • Glass of water with milled chia seeds (1 flush tablespoon)
  • Green juice with coconut oil (1 tbs, melted and emulsified with hand-held blender)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (powdered (2) or extract (1))
    • Cinnamon (powdered (2) or extract (1))

11:30-12:00 – Lemonade

  • Lemonade and Vitamin C (as above)

12:00-12:30 – Salty veggies

  • Cucumber, kohlrabi or celery with salt
  • Supplements:
    • Enzymes (3)
    • Tulsi
    • Lugol’s
    • ATP Cofactors
    • Green tea extract
    • Green coffee bean extract

13:00-15:00 – Workout

  • Resistance and high intensity interval training on Mondays
  • Pilates on Tuesdays, Wednesday and Thursdays
  • Cross Fit training on Fridays
  • Rest on Saturdays and Sundays

15:00-:15:30 – Gren juice and coconut milk pudding (or ice cream)

  • Green juice without coconut oil
  • Coconut milk pudding or ice cream (blueberry, raspberry, blackberry or raw cacao and chia)
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)
    • Krill Oil (2; Mercola)
    • Astaxanthin (Nutrex)
    • A/D/K2 (DaVinci Laboratories)
    • Zinc (MegaFood)

15:30-16:30 – Sleep

Sleep (highly recommended; optional after the first five days)

16:30-17:00 – Water

  • Large glass of water
  • Supplements:
    • Enzymes (3)
    • Spirulina (3) / Chlorella (5)
    • Probiotics
    • Green tea extract
    • Green coffee bean extract

17:30-18:00 – Lemonade

Lemonade and Vitamin C (as above)

18:00-18:30 – Salty veggies

Cucumber, kohlrabi or celery with salt

19:00-20:00 – Green juice, salad and coconut macaroons

  • Green juice without coconut oil (then wait 30 minutes)
  • Green leafy salad with oil and salt (no vinegar), and small amount of either walnuts, anchovies, sardines or salmon (smoked, grilled or pan fried)
  • Coconut macaroons for dessert.
  • Supplements:
    • Niacinimide (2)
    • Turmeric (2)
    • Cinnamon (2)

22:00-22:30 (just before bed)

  • Supplements:
    • NightRest
    • Valerian root extract

Concluding remarks

This is a programme designed for reversing type II diabetes, and will, without any doubt, do exactly this. What might vary from one person to another is really only the time that will be required to recover ideal insulin sensitivity.

It is important to appreciate, however, that it would be just as effective in treating any kind of degenerative condition like arthritis, but also atherosclerosis of the coronary or cerebral arteries, and arteriosclerosis due to the accumulation of calcium in the tissues; kidney or liver disease but also pancreatic fatigue or dysfunction; stomach and peptic ulcers, but also candida overgrowth and infection, as well as leaky gut syndrome; and of course, probably the most fearsome of them all—cancer.

Why? Because all health problems and disease conditions stem from biochemical and hormonal imbalances, and metabolic and physiological dysfunction. Therefore, in order to either prevent or correct any one problem, all problems must be prevented and corrected. For some of us—very few of us indeed—this is plainly obvious. It is, however, also obvious that this understanding is definitely absent—conspicuously and painfully absent—from modern conventional health care, no matter what it is intended to treat and no matter where we look.

Hence, it is my hope that this programme will not only help diabetics and pre-diabetics permanently reverse their diabetes and all the associated problems related to the underlying metabolic dysfunction, but also help all those who wish to treat whatever health concern they may have, as well as those who wish to prevent any such health problems from developing.

The only way to develop and nurture optimal health is for every cell, organ and system of the body to function optimally. Therefore, this is what we must do, and that’s the bottom line. Good luck with the programme. Naturally and as usual, you are welcome to post you comments, questions and observations, especially those from your experience with the programme. I would be very happy to hear from you.

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Reversing diabetes: understanding the process

The fundamental problem, the cause of all the complications associated with diabetes, is the chronically elevated glucose and insulin levels. Independently of the fact that each individual, each one of us, has a different tolerance to carbohydrates, a different metabolic response to the presence of glucose and insulin in the blood, there are basically only two ways that blood glucose can be elevated: the first is by the consumption of sugar or starch that finds its way into the bloodstream through the intestinal wall; the second is by the stimulation by stress hormones of liver glucose production whereby the glycogen reserves are broken down and the resulting glucose released into the blood. Therefore, in order to most effectively bring down chronically elevated blood sugar levels, it is essential to eliminate insulin-stimulating carbohydrates, but it is also essential to eliminate chronic stress.

The sugar

The vast majority of the millions of type II diabetics that constitute the body of what is now generally considered to be a diabetes epidemic in many western countries, have developed the condition primarily from the consumption of dietary insulin-stimulating carbohydrates, from eating high-sugar and high-starch diets over the course of decades. The process of growing insulin resistance due to chronic consumption of carbohydrates is described in several other posts (like, for example, We were never meant to eat simple or starchy carbohydrates, A diabetic’s meal on Air France, and Cure diabetes in a matter of weeks). It is for this reason that the same vast majority of type II diabetics responds extremely well to the elimination of these carbohydrates from their diet, whereupon glucose levels drops, insulin levels drop, the cells gradually regain insulin sensitivity, and the tissues and organs gradually recover from years or decades of the toxic environment created by continuously being exposed both to glucose and insulin. Naturally, the recovery process depends intimately on how long and how bad things were before implementing these dietary changes, but it happens in more or less the same way in every person.

The stress

The tendency, in many western societies, especially in North America, to create and generate in all sorts of ways very high levels of stress in most spheres of activities in our life, and, unfortunately, also thrive on this stress, often for years or even decades, in order to be highly productive, successful, and therefore important, or at least, make ourselves feel and believe that we are, is extremely bad. This, compounded with the fact that most of our standard western diets are very high in insulin-stimulating carbohydrates, makes the evolution towards of type II diabetes faster, more pronounced, and much more harmful. As a consequence, there is without a doubt a non-negligible fraction of diabetics that suffer from both a high intake of sugary and starchy foods, as well as high stress levels.

In the extreme, however, it is definitely possible to develop diabetes uniquely or primarily due to chronically high levels of stress. The most important, and indeed, very important difference between elevating blood sugar through diet or as a consequence of stress hormones, is that the former is naturally corrected by the secretion of insulin, which helps put aways the sugar either as glycogen or as fat, whereas the latter, the presence of high levels of stress hormones, simultaneously induces insulin resistance in order to keep the glucose in circulation as long as possible. This makes perfect sense from an evolutionary standpoint because under stress, under a fight or flight situation, we need lots of glucose in the blood and we want it to stay there to allow us to respond physically to whatever needs to be done: to run, jump, climb, fight, survive. The problem is that our high levels of stress are not only chronic, but they are not associated with a situation in which we need to have access to high levels of sugar in the blood in order to respond to the stressor physically with our muscles. And so, glucose remains high and circulates, insulin remains high but is not effective, and from this, all our blood vessels, tissues and organs get damaged: glycated from the glucose, oxidised from the free radicals, and literally corroded by the insulin.

This clearly implies that chronically high levels of stress are far worse than a high carbohydrate diet, and explains in no uncertain terms why high-stress professionals—even low-carb eaters—can not only suffer from chronically elevated blood sugar levels and the full array of damaging consequences, but also develop diabetes, and almost inevitably, heart and artery disease, because they all come from the same place: high stress leads to high levels of cortisol and other stress hormones; high levels of stress hormones lead to high glucose and insulin resistance no matter what is eaten because it comes from the liver; high glucose levels and insulin resistance leads to artery disease which leads to heart disease, and it also leads to type II diabetes. This is why, for those high work volume and high stress high-strung high-achievers, it is essential to eliminate all insulin-stimulating carbohydrates, but it is crucial to significantly reduce, and ideally, eliminate chronic stress. (We have looked at many of the physiological effects of stress in The kidney: evolutionary marvel and in At the heart of heart disease.)

The physiological consequences

As every diabetic knows, or at least should know, the consequences or complications associated with the condition of diabetes are horrific. What is very unfortunate is that it appears as though many doctors do not understand the biochemical and physiological connections and chains of  reactions and responses that develop and grow more sever over time as a consequence of the underlying chronically elevated blood sugar and insulin levels (as you may remember from your reading of Why do diabetics have high blood pressure?). What happens in the body when levels of blood sugar and insulin resistance stay high? Let’s follow this through:

High blood pressure, atherosclerosis and heart disease

The most immediate consequences are the rise in blood pressure and increased damage to blood vessels from glycation: the elevated levels of glucose that the kidneys have evolved to keep in circulation causes a rise in osmolarity (blood concentration), which the kidneys try to counter by retaining water in order to keep the blood from getting too concentrated. Since blood pressure is mostly a function of the amount of water in the blood, this causes the pressure to rise. Because glucose is meant to remain in minimal circulating concentrations or otherwise be quickly cleared from the bloodstream by pancreatic insulin shuttling it into cells, long-lasting elevated sugar concentration leads to the glycation of tissues, which is the damage of protein or fatty structures of the cells due to the glucose molecules “sticking” in the wrong places and in the wrong way. This, in combination with the higher blood pressure, is the perfect recipe for much increased damage to the blood vessels, especially the large arteries in which the pressure is greatest, the increased production of cholesterol and lipoproteins for cholesterol transport and damage repair, and the consequent plaque buildup termed atherosclerosis, which eventually (sooner than later) leads to artery disease, heart disease, and heart attacks from the occlusion of vessels bringing blood to the heart muscle (the coronary arteries).

Kidney disease

Even though it is the kidney that regulates the blood pressure and retains water in order to keep the blood from getting too concentrated with the increasing concentration of glucose, the higher blood pressure puts great strain on all of its micro filtering units, the nephrons, whose function is to filter out acidic metabolic waste from the bloodstream and get rid of it through the urine. The nephron works optimally under optimal conditions, but optimal for it, which means ideal blood pressure: not too low, but especially, not too high. It’s a self-regulating system in that if we are relaxed and at rest, then breathing is slow, heart beat is slow, blood circulation is slow, blood pressure is low and the kidneys are under little strain. As we get moving, through exercise, for example, then breathing is faster, heart beat is faster, blood flow is faster, blood pressure is higher, and the kidneys filter a larger volume of blood per second in order to eliminate as much of the acid that is building up from the activity and that needs to be eliminated in order for the muscles to continue working in ideal conditions.

With chronically high blood pressure, the kidneys are continually under stress and the nephrons get damaged. However, because there are millions of nephrons in each of the two kidneys, and it has been estimated that we can live with only 1/3 of the nephrons in only one of the two kidneys, this problem of the gradual deterioration of kidney function is not really considered as a big issue until the kidneys fail (or little time before), at which point it is far too late, and the situation is irreversible.

In addition, insulin resistance—to any degree—promotes the break down of muscle tissue, because as soon as sugar levels drop after a few hours after a meal or snack, during the night is the most apt example, since the cells cannot use fats for energy, the muscle tissue is broken down and constituents of its proteins made into glucose. This leads to chronically high levels of circulating creatinine that, as a metabolic waste product, must also be filtered out and eliminated by the kidneys. This happens in everyone with insulin resistance, and the amount of muscle breakdown is a function of the degree of insulin resistance. In the case of extreme insulin resistance as is seen in type II diabetics, the process is far more pronounced. The excessive stress on the kidneys inevitably leads to deterioration, nephron dysfunction, and eventually to failure. (You can read more about kidney function in The kidney evolutionary marvel.)

What makes things even worse is that most diabetics/heart disease sufferers have elevated lipoprotein (and cholesterol) levels due to the excessive inflammation and speed at which tissue damage is taking place in the blood vessels and all over the body. This, as you all know, has been wrongly interpreted and widely promoted as a major risk factor for heart attacks. The “treatment” of choice for these patients are a lifelong prescription for statin drugs. Very unfortunately, not only do statin drugs not confer any health or longevity benefits, but they accelerate the speed at which muscle breaks down, causing even greater amounts of creatinine to make its way into the bloodstream, and thus creating a heavy additional load on the kidneys. Is it any wonder that the rise in kidney disease closely reflects the rise in diabetes but also in statin consumption? If you’ve been taking statins, don’t get overly worried: physiological degradation is a slow process, and it is rarely too late to make the intelligent choices and changes that will help stop and reverse the disease process, and in time allow the body to heal itself.

Systemic acidosis

The way in which the kidney regulates blood pressure upwards is by secreting different hormones that prevent water from being eliminated, that thicken the blood, and that contract the blood vessels. In most people, the majority of which is chronically dehydrated, there is already a shortage of water and therefore a dehydration response by the kidneys; the elevated sugar concentration makes this far worse, of course. And under dehydration conditions, the means by which the kidney can retain even more water, as much water as it can, is by increasing the concentration gradient in the interstitial medium through which the nephron passes in order to pull as much water out of the filtrate as possible.

Increasing the concentration gradient is done by keeping and concentrating sodium and uric acid. It is more important to retain water than to eliminate uric acid, because water is primordially important for all body functions. Consequently, urea and uric acid levels rise, gradually but consistently over time. Because acid cannot accumulate in the blood, whose pH must absolutely be kept pretty much exactly at 7.4 (7.35-7.45), but because, at the same time, it cannot be eliminated by the kidneys under the given circumstances, it is stored away in the tissues all over the body: joints, ligaments, tendons, muscles and organs. Chronically high levels of uric acid in the blood lead to the condition known as gout. The buildup of acid in the tissues leads to pain, inflammation, arthritis, cartilage breakdown, bone demineralisation and osteoporosis, and a slew of other undesirable consequences, including increased susceptibility to all forms of infections: yeast, viral and bacterial, and severely depressed immunity. (You can read more about acidosis and alkalisation in A green healing protocol, Detoxification, and Such a simple and yet powerful natural anti-inflammatory.)

Maybe the most critical point about acidosis in how it relates to diabetes is that the pancreas and its precious beta cells, those that produce the insulin, are extremely sensitive to pH, and simply cannot function when the blood and cellular environment is acidic. The cells simply stop functioning because of the overload of acid that is not excreted and not neutralised. This makes the pancreas more and more dysfunctional over time, and eventually leads to exhaustion and the complete inability to secrete insulin or do any of the other functions that it is intended to perform. Something very similar happens in the liver, and, in fact, everywhere else, when chronic acidosis defines the internal environment of the body.

Pancreatic exhaustion

The distinction between type I and type II diabetes is usually highlighted by calling the first insulin-dependent diabetes, and the second insulin-resistant diabetes. Type I diabetics are usually identified and diagnosed as children or young adults because their pancreas does not produce insulin, and are then “treated” by having to inject themselves insulin after they eat for the rest of their lives. Naturally, over time, from the continual and usually excessive exposure to insulin, their cells become insulin-resistant, and they subsequently develop all the same problems as type II diabetics, whose condition is, in a way, exactly the opposite, in the sense that they suffer from chronic hyper-insulinemia, because their pancreas that senses the elevated glucose concentration in circulation, produces more insulin in order to clear it out and store it away. The problem is that the cells are not sensitive to the presence of insulin, and therefore do not take in the sugar. The pancreas is then forced to produce and secrete more insulin, and on it goes. Amazingly, type II diabetics are also “treated” by insulin injections, which increase insulin levels even more, and increase insulin resistance even more, obviously making the situation far worse. Eventually, the pancreas of the type II diabetic gets completely exhausted, and loses the ability to manufacture and secrete insulin. At this point, the type II becomes a kind of type I. Interesting how this goes, isn’t it.

The pancreas’ main function is not to secrete insulin, even though in our diabetic-centric worldview it is certainly considered as such. This is one of its functions, but not the most important. By far the most essential is the production and secretion of enzymes, the specialised proteins that break down foods but also do everything else that needs to be done, especially tissue building and repair throughout the body. The third essential function of the pancreas is the concentration and secretion of sodium bicarbonate in the small intestine following the movement of the pre-digested chyme from the stomach into the small intestine. This is also extremely important because all absorption and digestion in the intestine must take place in an alkaline environment, compared to the acidic environment required in the stomach when protein is present. Pancreatic exhaustion from the over-production of insulin for years on end, therefore spells disaster on many more fronts than just insulin and glucose metabolism. It spells disaster for all digestion and absorption processes, and all enzyme regulated activities, which basically means everything, really. This is very serious.

Liver dysfunction

The liver does an amazing amount of vital work, most of it incredibly complex. This includes filtering the blood from all sorts of toxins, both biological and chemical in nature, and breaking those down for elimination; it includes the manufacture of cholesterol and lipoproteins, vital for survival, but the details of which are so intricate that they are still not completely understood after a century of study; it includes the transformation of excess glucose into glycogen and into fat for storage; and in includes the manufacture of glucose from liver-stored glycogen to continually adjust the levels of glucose in the circulation depending on the body’s needs, or more specifically, on the hormonal and biochemical environment. The distinction may appear subtle, but it is quite important in the sense that it is really the hormones and biochemistry of the blood that regulates the function of most tissues and organs, especially those of the vital glands like the liver, pancreas and adrenals, and there is hardly anything more disruptive and unbalancing to the hormonal and biochemical makeup than chronically elevated glucose, stress hormones and acid levels.

Under such conditions, the liver must manufacture an inordinate amount of glucose from the glycogen stores that it itself must also replenish, but also from the broken down muscle tissue. At the same time it converts as much as it can of the glucose into fat for storage, but unfortunately, insulin resistance makes it impossible for the triglycerides to be used, and they are therefore left in circulation for longer than they should before eventually being stored in our fat cells. To top up the list, the free-radical and glycation damage to the vessels and tissues require the liver to also manufacture an inordinate amount of cholesterol and lipoproteins in an attempt to repair these damaged cells, which is no small feat, (you can read more about cholesterol and lipoproteins in But what about cholesterol? and in Six eggs per day for six days: cholesterol?). All of these processes are perfectly natural. However, they are not meant to be running in overdrive for years on end. It is no surprise then that imposing upon the liver to cope with this, eventually leads to dysfunction, deterioration, exhaustion and failure.

Towards a working solution

This is definitely not the end of the list of the complications and physiological consequences that develop from chronically high circulating glucose and insulin levels, but they are some of the most important. Also, it is essential to understand the process by which these consequences first arise and then grow in severity and into the disease process over time. It is, however, infinitely more useful to know what to do in order to maintain a biochemical and hormonal environment in which none of these various dysfunctions and complications can arise if they haven’t yet, or how they can be stopped and reversed if they have.

It shouldn’t be surprising that these are the same, and that they are keys to any optimal health plan, simply because the cells, tissues and organs that make up the human body function, or rather, should function in the pretty much the same way in everyone, allowing for small differences in some of the details. For example, the fact that different people have different tolerances to carbohydrates does not change anything to the consequences of chronically elevated glucose levels on physiological function. It only changes the details relating to the thresholds and time scales involved in developing the same problems. The same goes for vitamin D: the fact that different people require different amounts of vitamin D in order to remain healthy does not in the least alter the basic fact that virtually all complex living creatures depend on it for life. So, yes, everyone is different, but, at the same time, everyone is the same.

No sugars, no starches, no dairy

The first step to take is to eliminate from the diet foods that cause glucose and insulin levels to rise. For this, we must

  1. Eliminate all simple sugars: that’s basically anything that tastes sweet, including sweet fruit, because all simple sugars will elevate blood glucose levels almost immediately after consumption;
  2. Eliminate all starchy carbohydrates: that’s all grains and grain products (at least 90% carb), beans (typically more than 70% carb), potatoes (virtually 100% carb), and other starchy veggies like sweet potatoes, yams, taro, etc, because the starches they contain are broken down to glucose by enzymes in the digestion process; but also sweet root vegetables like carrots and beets, which are just full of simple sugars (you’ll know this if you’ve ever had carrot or beet juice?)
  3. Eliminate dairy: that’s all milk products, which, even those low in sugars like hard cheeses, cause a rise in insulin levels. Besides, most people are allergic or intolerant to dairy products, whether they are aware of it or not.

And aside from just glucose and insulin levels, as we discussed in At the heart of heart disease, insulin-stimulating carbohydrates are highly inflammatory, triggering more than 300 inflammatory pathways. So, excluding them from our diet not only brings about plenty of positive metabolic and physiological changes, but it is, as far as I am concerned, a requirement to make those positive changes happen.

Drop the stress

For those people to whom we referred to earlier that suffer mostly from the chronically elevated stress hormone levels, it is crucial to eliminate the causes of stress, ensure long hours of high quality sleep, and incorporate exercise and activities that effectively reduce stress levels, as well as supplements that can help with that. Obviously, the most important sources of stress for most professionals are psychological ones. But what is also well established is that the level of stress that is experienced (i.e., the amount of stress hormones secreted and in circulation) depends entirely on each person’s outlook and attitude. Therefore, it is this—the attitude and outlook—that are the most influential factors in generating or relieving stress on a daily basis.

Having said this, it is also obvious that going to a remote holiday house on sandy beach without access to phone or internet communications, and making a point of simply relaxing, going for walks, swimming in the sea, reading good books, watching good films, taking naps, eating healthfully and sleeping long and soundly every night, is inherently far more conducive to eliminating stress than the usual school year and work day conditions. What we must find a way to do is to function well in all circumstances with minimal stress, and most importantly, without chronic stress. It is chronic stress that is the problem; not relatively short periods of high stress. And stress, it shouldn’t be surprising, is also happens to be extremely acidifying (haven’t you ever noticed the strong, acidic smell of underarm stress sweat?).

Very helpful in this is taking Tulsi in the morning and at lunchtime (only during the day), and valerian root before bed. But exercise, conscious relaxation, and modifying outlook and attitude towards a more open and relaxed position are definitely most important.

Lower blood pressure

Lowering glucose levels will automatically lower blood pressure. Lowering stress will also automatically lower blood pressure. Biochemically though, the most important muscle relaxant—and this most definitely applies to the smooth muscle cells that line the blood vessels—is magnesium. Therefore, magnesium baths, oil and oral supplementation is essential. On the other hand, calcium is contractile and unfortunately, much more present in the foods we eat. Therefore, most of us are magnesium deficient but also over-calcified. Hence, minimising calcium intake is also very important. (You can read more about these topics in Minerals and bones, calcium and heart attacks, and in Why you should start taking magnesium today.)

Proper mineral balance, especially sodium and chloride, are essential for blood pressure regulation. Eating plenty of unrefined sea salt with meals (and with drinks) is also crucial. Naturally, we seek balance, and salt intake has to be balanced with water intake, and this leads to optimal kidney function. (You can read more about water, salt and physiological function in How much salt, how much water and our amazing kidneys, Why we should drink water before meals, and in Water, ageing and disease)

Support the kidneys

The kidneys want to maintain optimal blood pressure; regulate water, sodium and mineral content of the blood; and clear out metabolic wastes, mostly uric acid. To have them do what they are trying to do as best they can, we must very simply provide plenty of water, plenty of unrefined salt rich in sodium and all the other essential minerals, plenty of alkalising sources in drink and food, minimise glucose levels and minimise creatinine levels. The importance of alkalising the body intensely at first and continuously thereafter cannot be overstated with regards to the proper function of all the vital organs discussed here, and everything else really: every cellular process and every enzymatic action; everything depends on this.

Rejuvenate the pancreas

The pancreas senses and responds to glucose in the blood by manufacturing and secreting insulin. It responds to the movement of food from the stomach to the intestines by manufacturing and secreting sodium bicarbonate and digestive enzymes. To rejuvenate the pancreas, we need to not only give it a break, but help it recover. For this, we need to minimise glucose levels in the blood, and thereby minimise the need for it to manufacture insulin; maximise intake of enzymes to minimise the need for it to produce them; and, especially in light of what we discussed under acidosis, we need to maximise alkalisation, including through oral and transdermal absorption of sodium bicarbonate and magnesium chloride, with a focus on chlorophyl and chlorophyl-rich foods and drinks.

Cleanse the liver

The liver’s most taxing function is the breakdown of toxins (all substances foreign and dangerous to the body). Another taxing function of the liver is the manufacture and recycling of cholesterol and lipoproteins that, as we said earlier, are in production overdrive because of the excessively fast free-radical and glycation damage to the lining of the blood vessels, as well as the damage these cause everywhere else in the tissues of the body, accompanied by the chronic systemic inflammation this leads to (you can read more about systemic inflammation in Treating Arthritis and At the heart of heart disease.)

To help the liver, we must therefore first stop ingesting chemically manufactured medications, and we must eliminate sources of toxins and chemicals from the things we eat and drink; from the air we breathe, especially from those toxic cleaning products we use; and from all the chemicals we absorb through the skin in soaps, shampoos, lotions and creams. Second, we eat and drink to minimise inflammation and internal tissue damage, therefore minimising the strain of excessive manufacture of cholesterol and lipoproteins. And third, we must take regular toxin cleansing and alkalising baths with sodium bicarbonate and magnesium chloride. This simple therapy is the most effective means of detoxifying the body from chemicals and toxins or all kinds, including the most notorious radioactive isotopes that can make their way into our bodies from nuclear weapons, spills and power plant accidents through the air, water and food. Here again, chlorophyl and chlorophyl-rich foods and drinks are essential.

In conclusion

The basic conclusion is the same as what we have come to whenever we discussed type II diabetes: while it is a devastatingly damaging condition that affects every metabolic and physiological function of the body, it is incredibly easy to prevent, and even after many years of deterioration for the diabetic sufferer, it is relatively easy to reverse the condition and cure the disease, including the beta cells of the pancreas, by understanding the disease process thoroughly, and by adopting an appropriate healing protocol. Here, we have detailed several of the key problems or complications that stem from chronically elevated glucose and insulin levels, with specific discussion of the ensuing dysfunction in some vital organs, and highlighting the crucial importance of considering the effect of stress in addition to the effects of dietary insulin-stimulating carbohydrates.

You might have noticed that a discussion revolving around overweight, obesity and fat metabolism is missing, maybe conspicuously so. This is not an oversight, but a conscious move towards a focus on the underlying causes of the metabolic, hormonal and physiological natures of the disorder instead of the superficial and rather inconsequential repercussions of it that take expression in the form of excess body fat. The only point I want to mention about this is that by correcting the causes of the disorder, excess body fat stores will melt away on their own. Some help from supplements and hormonal manipulation through diet and timing here and there will be useful. But, the point remains that if the body is in optimal biochemical balance, then physiological and metabolic functions will also be optimal, and no excess body fat will remain, no matter how young or old we are, and no matter what our genetic makeup happens to be.

The overview of the basic strategy for preventing and overcoming diabetes should make it clear that what it implies, although in some aspects quite specific and targeted, is very simple in that it relies mostly on drinking clean water, eating unrefined salt and clean foods, especially those that are chlorophyl-rich, eliminating damaging foods, chemicals and toxins, alkalising and detoxifying with sodium bicarbonate and magnesium chloride, and finally, using a number of important supplements to correct deficiencies and restore optimal biochemical balance. In a subsequent post we will formulate a detailed programme that incorporates all of the elements and strategies discussed here in general terms, together with some additional considerations about details like the timing and amount of food, drink, exercise and supplements.

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Why do diabetics have high blood pressure?

This is the question that someone in the audience asked at the end of a presentation on diabetes that I attended a few months ago. Remarkably, the speaker was unable to answer this question. Amazingly, neither could any one of the three medical doctors that were in attendance. I was, naturally, quite shocked by this obvious display of ignorance on all of their part. At the same time, I wasn’t really surprised, and, in fact, relieved to be vindicated in my belief that probably the majority of MDs don’t understand the most basic things about human physiology and metabolic function.

Now, you, on the other hand, you who has been following and reading this blog, might (or even should), I believe, be able to answer that question. But since you’re reading this, and therefore cannot be put on the spot, as was the speaker and those MDs at that presentation, you don’t have anything to worry about if you can’t. And yes, I am going to explain. On top of that, I’ll be as quick as I can about it.

As always, first things first: How is blood pressure regulated? What is it that does the regulating? And why is it important?

Blood pressure regulation is of the utmost importance for the proper functioning of every organ because every cell in the body depends on a properly functioning circulatory system to bring nutrients and carry away waste. Blood pressure is like the voltage that drives current through wires and electronic components: it is a driving force. And exactly like it is for electric and electronic devices, the driving force must be just right: it cannot be higher and it cannot be lower than what it needs to be in every moment depending on what the immediate circumstances and needs happen to be. Therefore, blood pressure regulation is essential for the moment to moment adaptation of every metabolic and physiological function, to the different activities we do, and circumstances we find ourselves in.

The main organ responsible for blood pressure regulation is the kidney. I use the singular because the two kidneys work in the same way. It’s just that their function is so vitally important that there are two of them, most logically for redundancy, as a fail-safe system. I have written at length about kidney function in two articles entitled The kidney: evolutionary marvel; and How much salt, how much water, and our amazing kidneys. By the way, this is what I meant earlier: if you’ve read those, understood and happen to remember a few essential bits, then you would be in a good position to answer the question as to the relationship between diabetes and blood pressure. Here it is in a few words; well, maybe a few paragraphs.

The kidney’s vital role is filtration of metabolic acids out of the blood, and elimination of these through the urine. To do this as best it can, because the first and most important part of the filtration process relies on the separation of the liquid from the solids in the blood, and because this is done through what is a mostly “mechanical” filtering through a membrane as it is in water filters, the kidney must maintain optimal pressure to ensure optimal function of the little filtering units, the nephrons. If pressure is too low, the membrane filtering does not work well. If pressure is too high, the membrane tears or pops, and the filtering units stop working altogether.

The good news is that damaged nephrons can sometimes recover when the conditions are made conducive to it, and that there are millions of them in each kidney. The real bad news is that when they die, they do not come back to life. Another bit of bad news, although some would surely take this as good news instead, is that this process of deterioration of kidney function and death of nephrons takes place gradually but silently over the years and decades of our life. When the consequences of poor kidney function become noticeable or even critical, and we finally go see our MD because we’re not feeling good, or worse, are brought directly to the emergency room, it is far too late, for most of the nephrons are already dead.

And to be perfectly clear on this, if the kidneys fail and we don’t get immediate attention and artificial filtering of the blood through dialysis, we die within hours. This is what is meant by the word vital when qualifying the kidney as such an organ.

As I often highlight, the cells, tissues and organs that constitute the entirety of the body that we erroneously call ours and mistakenly believe this to be the case, do not care about you in the least. They do not know anything about you and never will. They, as all living things, are only concerned with survival and self-preservation. It is for this reason that they continually adapt in all sorts of ways to the environment in which they find themselves: this is the internal environment of the body. And it is for this reason that the kidney regulates blood pressure so accurately and so well when allowed to function as it should.

How does it do this regulating? By very closely monitoring the concentration of the blood and secreting hormones to induce the necessary adjustments. The concentration of the blood is the balance between the amount water and the amount of solutes (things dissolved in the water). Most important is the amount of water, because it gives the blood its volume and thus pressure within the closed circulatory system of somewhat malleable veins and arteries. Of the solutes, the most important is sodium, because it holds and must be held in the highest concentration of all solutes, accounting for about half of the overall solute concentration (140/300 mOsmol/L). But the kidney works to keep the entire spectrum of natural solutes, especially the minerals, each in its optimal physiological range.

Two nutrients that the kidney works to keep in circulation are proteins and glucose for the obvious reason that they are essential to proper physiological function, and, evolutionarily speaking, rather rare to come by and thus precious. As they are also solutes circulating in the blood plasma, each contributes to the total concentration. And this is where we get to the point:

As glucose concentration rises, the total concentration of the blood rises accordingly. For insulin-resistant diabetics whose cells have lost their sensitivity to insulin, and with that their ability to take up glucose from the blood, there is no outlet for this excess glucose that just keeps on rising in concentration. But unlike what the kidney does in regulating the concentration of sodium and other minerals by excreting any excesses through the urine, glucose is kept in circulation, as much as possible.

After some time, whether because the concentration is through the roof, because the kidney cannot anymore function as it should to keep the glucose in the blood, or both, glucose spills into the urine. This is how, in fact, it was discovered that all of the symptoms that we described as the condition of diabetes are due to a dysfunctional metabolism of glucose: because the urine of diabetics was sweet smelling and sweet tasting. (What dedicated MDs we had 100 years ago! Do you think your MD would taste your piss today to make sure you’re not sick?).

In response to this, to maintain the concentration as close to 300 mOsmol/L as possible, the kidney retains water to dilute the blood from the excessive glucose. This makes the blood volume increase and therefore also the blood pressure. This is why diabetics have high blood pressure. This is also why diabetics have very high incidence of kidney disease. This is also why diabetics have water retention and circulatory problems.

But this is also why they suffer from a lot more strokes, heart attacks, Alzheimer’s, dementia, arthritis, why they have elevated cholesterol, why they age so much faster, and why they go blind.

Chronically elevated glucose leads to chronically elevated levels of glycation. Glycation damages cells and tissues everywhere in the body, but firstly in the veins and arteries, which are already significantly more susceptible to damage because of the chronically elevated blood pressure. This leads to more and faster plaque formation, as well as cholesterol production for damage control and repair. Elevated glucose levels and heightened glycation lead to a flood of free radicals and vastly increased systemic inflammation, which makes everything worse, much worse.

And all of these conditions, all stemming from insulin resistance and chronically elevated blood sugar, give rise to the multiplicity of the health problems just enumerated that are the main causes of death in the general population, but which are seen with an approximate three to four fold increase (that’s 300-400% more!) in incidence for a given age in the diabetic population.

What about non-diabetics? Do they need to be concerned about this? Does it mean that there is a direct relationship between blood sugar and blood pressure in all of us? Does it mean that all of us suffer from the whole lot of direct and indirect consequences of having high blood glucose concentrations in the same way as diabetics do, but in proportion to the concentration and the time it takes for it to drop depending on insulin sensitivity? What do you think?

Is any of this surprising? Not in the least: it makes perfect sense. Is it difficult to understand why it happens? Not really: when we understand some basic physiology and biochemistry, everything becomes relatively easy to grasp and explain. At least that’s what I hope I was able to show here, and at the very least, in regards to the question posed in the title that we set out to answer in the first place. You got it, right? And you’ll remember? And next time you see your MD, (if you have one, that is), ask them why diabetics have high blood pressure, and see what they say…

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Cure diabetes in a matter of weeks

Both the incidence and growth rate of insulin-resistant diabetes have reached epidemic proportions in many countries. It is most remarkable in the US with probably close to 30 million by now, and thus about 10% of the population (1, 2). Globally, the numbers are even more impressive: 370 million with diabetes predicted to grow to 550 by 2030 (3). This entails that as a disease, type-II diabetes (90% of diabetics) is one of the fastest growing causes of death, now in close competition with the well-established leaders, cardio-vascular disease and cancer, that each account for 25% of deaths in more or less all industrialised countries.

Insulin-resistant diabetes is very similar to both vascular disease (cardio and cerebro) and cancer, as well as intestinal, kidney, pancreatic and liver disease, arthritis, Parkinson’s and Alzheimer’s, in the sense that it is also a degenerative disease that develops over a lifetime, or at least over several decades. It is, however, quite different from all other chronic degenerative diseases because it is, in a way, the ultimate degenerative disease, in which the occurrence of all others increases markedly, and in some cases two to four times (4).  That’s not 10 or 15%, this is 200 to 400% more!

For this reason alone, it seems clear that all these degenerative conditions are intimitely related, and that furthermore, understanding insulin-resistant diabetes will most definitely give us keen insights into the genesis of degenerative diseases in general.

What boggles the mind is that, in a very real sense, we understand precisely and in exquisite detail how and why insulin-resitant diabetes develops, how and why it is related to all other degenerative diseases, and consequently, both how to prevent diabetes and all disease conditions for which it is a proxy, and why what is needed to achieve this actually works (5, 6).

In fact, type-II diabetes can be cured; not just controlled or managed, but cured; not just partially or temporarily, but completely and permanently. And this, in a matter of weeks.

This may seem simply impossible to the millions of suffering diabetics that live with their disease for years and more often decades, but it is the plain and simple truth, which has been demonstrated by more than one, but unfortunately rather few exceptional health care practitioners, already several decades ago by Robert Atkins (7), and more recently by Ron Rosedale and Joseph Mercola, for example (89), in a remarkably repeatable, predictable and immensely successful manner on most probably tens of thousands of people by now.

About insulin and glucose (or should it be glucose and insulin)

Insulin is a master hormone one of whose important roles is to regulate uptake of macronutrients (carbs, proteins and fats) by facilitating their crossing the cellular membrane through channels guarded by insulin receptors, from the bloodstream into the cell, either for usage or storage. It is for this role that insulin is mostly known.

However, arguably insulin’s most important and critical role is the regulation of cellular reproduction and lifespan, a role which is, as amazing as it may seem, common to all animals that have been studied from this perspective, from microscopic worms to the largest animals.

As such, insulin is a master and commander for regulating reproduction and growth in immature and therefore growing individuals, and regulating lifespan and ageing in mature and therefore full-grown adults (10).

Insulin is absolutely essential to life because in its absence cells can neither use glucose—a most basic cellular fuel, nor reproduce correctly—making growth impossible. It is, however, needed in only very small amounts. Why? Because insulin is very damaging to tissues and especially blood vessels, something that has been well known for a long time (look at this short review on the role of insulin in atherosclerosis from Nov 1981—that’s 32 years ago!, and you’ll see what I mean.)

Insulin is secreted by the beta cells of the pancreas in response to glucose concentration inside of these. As blood passes through the pancreas, these special cells that produce and store insulin, sense how much glucose there is by taking it in, and release insulin into circulation proportionally. This release is pulsed (while eating, for example) with a period of between 5 and 10 minutes, but only in response to blood sugar concentration, meaning that insulin is released only if blood sugar rises above the individual’s threshold, which depends on the metabolic and hormonal state of that individual.

However, it is important to note that pretty much no matter what the metabolic or hormonal states may be, eating fat and having fatty acids circulating in the bloodstream does not stimulate the release of insulin, while eating protein, in particular the animo acids arginine and leucine, does, albeit a lot less than glucose. This is because insulin is generally needed for cells to take in and use amino acids.

An insulin molecule that has delivered a nutrient to a cell can be degraded by the cell, or it can be released back into the bloodstream. A circulating insulin molecule will be cleared by either the liver or the kidneys within about one hour from the time of release by the pancreas.

Exposure to most substances, including lethal poisons such as arsenic and cyanide, naturally and systematically decreases sensitivity, or from the reverse perspective, increases resistance to it (as demonstrated by generations of Roman emperors and their relatives). This applies to cells, tissues and organs, and happens in the same way for biochemical molecule like messenger hormones, for the one that concerns us here, insulin. Thus, as cells are more  frequently and repeatedly exposed to insulin, they lose sensitivity and grow resistant to it.

Insulin primarily acts on muscle and liver cells where glucose is stored as glycogen, and on fat cells where both glucose and fats are stored as … fat, of course. Muscle cells grow resistant first, then liver cells and in the end, fat cells. Fortunately or unfortunately, endothelial cells (those that line the blood vessels), do not become resistant to insulin, and this is why they continue to store glucose as fat, suffer severely from glycation, and proliferate until the arteries are completely occluded and blocked by atherosclerotic plaques.

What happens when a large portion of the muscle and liver cells, and enough of the fat cells have become insulin-resistant? Glucose cannot be cleared from the bloodstream: it thus grows in concentration which then stays dangerously high. This is type-II, adult onset, or most appropriately called, insulin-resistant diabetes.

Unnaturally high glucose concentrations lead to, among other things, increased blood pressure, extremely high rates of glycation (typically permanent and fatal damage) of protein and fat molecules on cells throughout the body, heightened stimulation of hundreds of inflammatory pathways, and strongly exaggerated formation of highly damaging free radicals, which, all in all, is not so good. This is why insulin is secreted from the pancreas so quickly when glucose is high in the first place: to avoid all this damage and furiously accelerated ageing of all tissues throughout the body.

The five points to remember

  1. Insulin is a master hormone that regulates nutrient storage, as well as cellular reproduction, ageing and therefore lifespan.
  2. Insulin is vital to life, but in excess concentrations it is highly damaging to all tissues, especially blood vessels.
  3. If blood sugar is high, insulin is secreted to facilitate the uptake of the glucose into cells, but at the same time, because it is present, also promotes the storage of amino and fatty acids (protein and fat); if blood sugar is low, insulin is not secreted.
  4. Chronically high blood glucose is remarkably damaging to the organism through several mechanisms that are all strongly associated with degenerative disease conditions in general.
  5. Chronically high blood glucose concentration leads to chronically high insulin concentration; chronic exposure to insulin leads to desensitisation of muscle, liver and fat cells, and, in the end, to type-II or insulin-resistant diabetes.

And in this succinct summary, in these five points to remember, we have the keys to understanding not only how diabetes develops and manifests, to understand not only the relationship between diabetes and other degenerative diseases, but also to understand how to prevent and cure diabetes as well as degenerative conditions in general.

And I’m suppose to say …

But you already know what I’m going to say:

Because the basic, the underlying, the fundamental cause of insulin-resistant diabetes is chronic over-exposure to insulin, it means that to prevent—but also reverse and cure it—what we need is to not have chronic over-exposure to insulin. And this means to have the very least, the minimal exposure to insulin, at all times, day after day.

The good news, which is indeed very good news, is, on the one hand, that it is utterly simple to do and accomplish, and on the other, that almost independently of how prone we are to insulin resistance (genetically and/or hormonally) or how insulin-resistant we actually are right now, insulin sensitivity can be recovered quite quickly. And here, “quite quickly” means in a matter of days, which is truly remarkable in light of the fact that our state of insulin resistance grows over decades, day after day, and year after year. It is rather amazing, miraculous even, that the body can respond in this way so incredibly quickly.

Now, type-II diabetes is nothing other than extreme insulin-resistance. Naturally, the longer we are diabetic, the more insulin-resistant we become. But unbeknownst to most (almost all MDs the world over included), if your fasting blood glucose is higher than 75-80 mg/dl or your insulin higher than 5 (mU/L or microU/ml), then the muscle and liver cells are insulin resistant. And the higher the insulin, the more resistant they are. In fact, if you have any amount of excess body fat, your cells are insulin resistant. And the more body fat, especially abdominal but also everywhere else, the more insulin resistant they are.

Because insulin sensitivity is lost gradually over our lifetime through daily exposure, some consider that everyone is becoming diabetic more or less quickly, and that eventually, if we live long enough, we all become diabetic. But this is only true in a world where virtually everyone suffers from chronic over-exposure to glucose and insulin. It is not true in a world in which we eat and drink to promote optimal health.

In practice, because basically everyone is more or less (but more than less) insulin-resistant, concentrations around 10 mU/L are considered normal. But when I wrote earlier that insulin is vital but needed in very small amounts, I really meant very small amounts: like optimally between 1 and 3, and definitely less than 5 mU/L (or microU/mL; and the conversion from traditional to SI units is 1 mU/L = 7 pmol/L).

So how do we do it?

You already know what I’m going to say:

Because insulin is secreted in response and in proportion to glucose concentration, when it is low, insulin is not secreted. Therefore, insulin sensitivity is regained by completely eliminating insulin-stimulating carbohydrates. This means zero simple sugars without distinction between white sugar, honey or fruit; zero starchy carbs without distinction between refined or whole grains, wheat or rice, bread or pasta, potatoes or sweet potatoes; and zero dairy, which triggers insulin secretion even when sugar content is low. It also means minimal protein, just enough to cover the basic metabolic needs (0.5-0.75 g/kg of lean mass per day). Consequently, it means that almost all calories come from fat—coconut oil, coconut cream, animal fats from organic fish and meats, olive oil and avocados, as well as nuts and seeds—and that the bulk of what we eat in volume comes from fibrous and leafy vegetables.

And what happens? In 24 hours, blood glucose and insulin have dropped significantly, and the metabolism begins to shift from sugar-burning to fat-burning. In 48 hours, the shift has taken place, and the body begins to burn off body fat stores, while it starts the journey towards regaining insulin sensitivity. In a matter of days during the first couple of weeks, the body has released a couple to a few kilos of water and has burnt a couple to a few kilos of fat. We feel much lighter, much thinner, much more flexible and agile, and naturally, much better. In four weeks, blood sugar and insulin levels are now stable in the lower normal range. All of the consequences and side effects brought on by the condition of insulin-resisitant diabetes decrease in severity and amplitude with each passing day, and eventually disappear completely. In eight weeks, the metabolism has fully adapted to fat-burning as the primary source of energy, and we feel great. (See 11 for more technical details.)

The result is that within a matter of weeks, we are diabetic no longer: we have regained insulin sensitivity, and have thus cured our insulin-resistant diabetes. Over time, a few months or maybe a few years, feeling better with each passing day, there remain very few if any traces of our diabetes, and we live as if we never were diabetic. Amazing, isn’t it? So simple. So easy. So straight-forward. And yet, still so rare.

And what about the relationship between diabetes and heart disease, diabetes and stroke, diabetes and cancer, diabetes and Alzheimer’s? Why do diabetics suffer the various health problems that they do, like high blood pressure, water retention, blindness, kidney disease, and how do those come about? What of the lifespan-regulating functions of insulin, how does that work? All these interesting and important questions and issues will have to wait for another day. This article is already long enough.

If you enjoyed reading this article, please click “Like” and share it on your social networks. This is the only way I can know you appreciated it.

Two articles that changed my life

Two days ago, on October 23, I turned 40. For me, it feels different than every other birthday I have had: it feels like the marker of the transition between what can be considered young adulthood from 20 to 40, and middle adulthood from 40 to 70, which is then simply followed by old age. Maybe this is also linked to the fact that from the time I started competing, first in running track and field, then in road cycling, duathlon (running and cycling), off-road cycling and eventually in long distance running, I have always been in the normal, standard 18-40 category (like almost everyone else, I thought). And now, starting with my first race in the first level Seniors from 40 to 50 a couple of weekends ago in Bordeaux at the Ariane Cross 2012, I am definitely, and will be for the next 10 years, in the over 40 category. So, I have been reflecting a little on the past and the future: What is really important to me, what have I done and accomplished, what do I want to do in the future and how can I get there? Simple questions whose answers are not so simple.

In this context, I want to share two articles that completely changed my life, and completely changed my state of health, in some respects, rather suddenly, and in others, gradually over the years. Interestingly, I stumbled upon and read them both in the same week almost exactly five years ago. I won’t summarise, discuss their contents, nor describe the positive effects the simple but radical changes in dietary habits they prompted me to instil have had on me, on my wife Kristin and on our son Laurent. I simply encourage you to read them for yourself, and sincerely hope they will benefit you as much as they have us, and, I am sure, everyone who has ever read and applied the information they contain to their diet.

What is clear to me now much more than it has in the past, is that no matter what information we are presented, its impact depends entirely on how receptive we are to it. And this depends on all of what we know and think we know, on how we understand the connections between everything we have been exposed to, on our habits and tendencies, on previous experiences throughout our life, and very importantly, on the circumstances that form the context in which the information is brought to our attention. Thus, let me hope that these two articles come at a time that is ripe for you to appreciate their importance in regards to your own health, that of the people you care about, and everyone else for that matter.

The two articles are Insulin and Its Metabolic Effects by Ron Rosedale, MD (you can get the pdf here), and The Skinny on Fats by Mary Enig, PhD (get pdf here). After reading them, please consider sending this link to those you know who will or even possibly appreciate it. As you will see from the few case histories at the start of Rosedale’s presentation, the question of understanding and controlling insulin can really be a matter of life or death.

A diabetic’s meal on Air France

A few days ago, I was updating a reservation on the Air France website in anticipation of my trip from Madrid to Toronto on my way to the Origin of Stars and their Planetary Systems conference at  McMaster University. Looking through my personal profile, I found a section where to define a preference for the meals served on long flights. Looking through the list, I was intrigued by the “Diabetic” option.

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The fact is, I’ve read more than I ever intended about diabetes. That’s because the authors of most, if not all books that relate to natural health and nutrition in some way or another, usually have something to say about diabetes, more specifically, insulin-resistant or adult-onset or type II diabetes. One simple reason for this is that diabetes is so widespread in the populations of industrialised countries that it is almost ubiquitous. Another reason, certainly just as important if not more, is that the most common causes of death in industrialised countries—heart disease, stroke, alzheimer’s and cancer—are all much more common in diabetics than they are in non-diabetics, and in all cases, several-fold more common. Doesn’t this very naturally suggest that there is a fundamental relationship between insulin-resistant diabetes and these other conditions? Maybe even that what causes the development of the diabetic condition also causes the development of the others?

Type II diabetes, also called adult-onset diabetes, should instead always be referred to insulin-resistant diabetes in order to highlight the actual problem—insulin resistance. Unfortunately, it is only rarely referred to as such. Insulin resistance is a description of the state of a cell that does not allow insulin through its membrane to carry glucose to the inside of the cell—it resists insulin’s plea to let the glucose enter. The consequence of this is high levels of blood-glucose and insulin that don’t drop down as they should to acceptable, let alone ideal physiological levels. In fact, as far as I know, the primary, if not the only criteria used by  most MDs to diagnose the onset of diabetes is blood-sugar levels. It is considered normal to have blood-sugar levels anywhere between 65 and 110 mg/dl, but at 120 or above we are considered at risk of developing diabetes.

Interestingly, although fasting insulin concentration is a much better, more robust, indicator of not only the condition of insulin-resistant diabetes, but also of the gradual development of it, which does not appear from one year’s blood test to the next but rather develops over an entire lifetime, slowly and surely, it is almost never performed in standard blood tests ordered by general practitioners. It should.

And why is it better? Because instead of being subject to large fluctuations due to a myriad of different factors as is blood-sugar, such as carbohydrate intake, stress and physical activity, for example, fasting insulin is much more stable, decreasing steadily over the course of several hours, and reflects well the overall state of insulin resistance or sensitivity of our cells.

There is another more direct and accurate way of testing insulin sensitivity that involves measuring blood-sugar and insulin concentrations at regular intervals after ingesting a large amount of glucose. But this method is much more involved and lengthy. Fasting insulin is simple, easy, accurate and cheap. It really should always be done in standard blood tests. Request it on your next blood test. Although, if you follow the dietary advice on this blog, you should never even have to think about getting any blood tests done at all. I just do them because I find it interesting.

I discussed the insulin mechanism in We were never meant to eat simple or starchy carbohydrates, and also in When you eliminatie insulin-stimulating carbohydrates. But for just a second, forget what you remember about it, and consider the following:

Insulin is necessary to clear out excess sugar in the blood: it is the hormone that regulates fat storage. The greater the amount of sugar, the greater the amount of insulin required, and the greater the fat storage. The more often there is sugar, the more often insulin is needed. Insulin resistance in cells develops over time due to over-exposure to insulin, snack after snack, meal after meal, day after day and year after year.

Would we not then immediately conclude that in order to avoid developing insulin resistance we simply and straight-forwardly need to avoid raising blood-sugar levels? Furthermore, would we not immediately hypothesise that in order to reverse insulin resistance and regain insulin sensitivity we need to do just that: avoid raising blood-sugar levels? And how might we do that? You already know this: by not eating simple or starchy carbohydrates. Instead, eating most of our calories from fat to provide all the energy and calories needed for healthy cellular and hormonal activity throughout the body, and never or rarely be hungry.

Now, what was I served as the special order diabetic meal on the flight from Paris to Toronto that I am still sitting on? The salad was of grated carrots sprinkled with super dry, also kind-of-grated white meat, either of chicken, turkey of tuna, (I can’t tell because it didn’t have a smell and I don’t eat meat, so I didn’t taste it). The main course was of a piece of super-dry white fish on a bed of pre-cooked, dry, white rice with boiled frozen ripple-cut carrot slices. This was accompanied by not one of the classic crusty, refined white flour, mini-baguettes they serve on Air France flights, but by two of them. There were also two deserts, a small, dry-baked apple cut in two halves, and a soy-based pudding-like desert. Needless to say that I didn’t eat much of this meal. It was an experiment anyway: I was curious to see what a diabetic would be served, and now I know.

Before reading the next sentence, could you now tell me what is the main characteristic of the meal I just described?

It is a low-calorie, low-protein, super-low fat meal. As a consequence, it is a very high carbohydrate meal: there’s obviously nothing else it could be. Well, that’s not quite true: it is a very low-mineral and enzyme content meal, highly processed and totally dead. But that’s not really important, right? Only calories are important, right? And it is only important that it be low-fat, right?

Therefore, a diabetic that goes to the effort of ordering a special meal instead of the standard menu will end up consuming less protein, a lot less fat, and a lot more carbohydrates. This will cause a much greater rise in blood-sugar levels, that will in turn cause a much greater rise in insulin, and in the case of most diabetics will, in fact, require the injection of additional insulin because their cells are already mostly insulin-resistant. This will inevitably cause increased insulin resistance. But to make matters even worse than this already is, because they are eating very little fat, they will be increasingly hungry after each meal, and thus tend of overeat every time they get the chance. And overeat what? … carbohydrates. This is the definition of a vicious cycle. How sad. How incredibly sad.

I was just offered by second meal: it was pretty much the same thing with a cold dry meat salad instead of the re-heated dry fish with rice dish. What a laugh. This time, I just turned in down.

Oh, and by the way, the first meal was frozen almost solid. Every component, including the carrot salad, baked apple, soy desert and water: everything except for the main course that had been heated. And the second meal was also frozen, but this time, the air flight attendant felt quite sorry about it, and was rather sheepish when offering it to me. How funny! It’s a good thing I am used to fasting.

The worst mistake in the history of the human race

In We were never meant to eat simple or starchy carbohydrates, I mention those three books of Professor Jared Diamond that I have read, in the context of archeological evidence for the ill effects of the grain-based diet that our first farming ancestors adopted some 10000 years ago. This morning, I stumbled upon this article (link to pdf file) by him that was published in Discover magazine in May 1987. He boldly gave it the title The Worst Mistake in the History of the Human Race (link to Discover magazine’s online version with adds and everything else). It is a short article that presents the issue succinctly, but nonetheless convincingly, I think.

He doesn’t mention anything about insulin and its metabolic effects, (maybe he doesn’t even know anything about the topic). He only discussed archeological evidence and studies. But I think that if you were not completely convinced by my post that the human animal that we are simply shouldn’t be eating simple or starchy carbohydrates at all, then reading Diamond’s article will certainly help in that respect. If you were convinced, (which I truly hope is the case), I have no doubts that you will certainly find his article interesting, maybe even more so in the light of the physiological background presented in mine.

On the same topic, the very extensive work of Dr. Loren Cordain and his team turned him into a world scientific celebrity, and rightly so, I think. His public lecture on the Origins and Evolution of the Western Diet is really incredibly informative, interesting and eye-opening. Naturally, it goes in the same direction, but from a somewhat different angle.

Healthy and lucid from childhood to old age

So you’ve been around for 70 years, and you’re still well enough to read this. Have you actually made it past 75, 80 or even 85? This is really great! Through a combination of different factors, various reasons, personal habits and choices, you have made this far.

Maybe because of your genetic makeup: Your parents and grand-parents all lived well into their 80’s or 90’s by following a kind of innate, traditional wisdom based on the understanding that we really are what we eat, in a very real sense, and you’ve done more or less the same, following in their footsteps.

Maybe because you have always been moderate in your eating habits: You’ve never been overweight; you’ve never eaten much sweets or deserts; you’ve never eaten much preserved meats and canned foods; you’ve never drank much alcohol; you’ve never drank sweetened soft drinks, juice or milk—mostly just water, always paying attention not to drink too much coffee or strongly caffeinated tea.

Maybe you have made it this far because you have also been moderately active throughout your life, never exercising too much or too intensely, but always quite regularly: Walking; doing light exercises for your joints (rotations of the arms for your shoulders, stretches for your neck and back, and exercises for your knees); riding a bike a couple times a week in the good season, not getting off the bike but instead riding up those hills; maybe you went skiing a week or two most years; went for long walks or even hikes in the mountains during holidays; or did a little swimming in the sea or in lakes when the occasion presented itself.

The golden middleas my grand-father called it: everything is moderation. And he almost made it to 90 years of age! But no matter what the reason is, it is truly wonderful that you have indeed made it this far. Then again, you might be young or middle aged, but interested—maybe somewhat, maybe highly, but nonetheless interested—in being healthy and lucid for as long as possible, and hopefully well into your old age.

Either way, young or old, you live in this modern world like most of us. You live in a city, you drive a car, you work in an office, you fly or flew often on business trips, maybe even several times per week. You eat meat and fish; bread, potatoes, rice and pasta; fruits and vegetables, all from the supermarket.  And so you have, throughout your life, been continuously exposed to increasing amounts of chemicals, heavy metals and various other toxins in our environment, most of which have been accumulating in your tissues. You live in the modern world like most of us, and so you have taken medication on various occasions during your life: antibiotics a few times, maybe some pain killers, maybe some sleeping pills, maybe simple anti-histamines when you had a cold. Maybe you are and have even been taking medication on a daily basis for some “minor” but “chronic” condition.

You live in this modern world and so you have been told to drink plenty of fluids and that salt is bad and should be avoided. You’ve been told that fat in general, but especially saturated fats and cholesterol, are bad because they cause heart disease: they cause your arteries to clog up with fatty plaques that eventually block them to give you a heart attack. You’ve been told to avoid them as much as you can, and instead to consume polyunsaturated vegetable oils, plenty of whole grains and cereal products, legumes, plenty of fruits and vegetables, and so you have done that: you have decreased or almost eliminated your intake of butter, eggs, fatty cheese, fatty yoghurt, red meat—never ever eating the fatty trimmings, and also of the fatty skin on chicken or fish.

Consequently, you have increased your intake of morning cereal—but only sugar-free whole grain cereal like muesli; increased your intake of bread—but usually whole grain bread; increased your intake of rice—but usually brown rice; increased your intake of pasta—but usually also whole grain pasta; and increased you intake of potatoes—but never fried, only baked, steamed or boiled potatoes.

Maybe your total lipoprotein levels are around 220 or 240 mg/dl, and you have been told that this is too high, and for this reason you have tried to further reduce your fat intake, and are even taking statins or other cholesterol-lowering drugs, every day, just like hundreds of millions of other people in this modern world.

Unfortunately, you have not been told that you should be drinking water; not fluids in general, and that there are many reasons water, ageing and disease are intimately connected—the lack of water, that is. In addition to that, you have not been told that it is not enough to drink some water sometimes: it is essential to drink water before meals. Unfortunately, you have not been told that sodium is one of the most important minerals for health: why else would the kidneys, without which we cannot live for more than a few days, go to such great lengths to prevent its excretion in the urine, and keep it in the blood if it wasn’t? But even more unfortunately, you have not been told that minerals in general, are essential for health, and that unrefined sea salt contains all naturally occurring trace minerals is proportions that closely match those of several of our bodily fluids. And that furthermore, proper bodily function depends intimately on the balance of the minerals available, and that our salt-phobic and calcium-phillic society has led to most of us becoming completely over-calcified while growing more and more deficient in the rest of the trace minerals, and in particular magnesium. The link between generalised magnesium deficiency and minerals, ageing and disease are now everywhere painfully obvious.

Unfortunately—and indeed very sadly—you have not been told that cholesterol is absolutely vital for life and good health: that it forms the membrane of every single cell in your body and in that of every animal, that your entire nervous system and especially your brain are built using cholesterol and depend intimately on the availability of plenty of cholesterol, that your hormonal system relies completely on cholesterol for building hormones, and that your best defences against infectious and inflammatory pathogens are in fact the lipoproteins carrying around the precious cholesterol throughout your body. You have not been told that cholesterol is so important that it is manufactured continuously by our liver to keep up with the body’s needs, and that therefore, the cholesterol we eat does not in any ways raise lipoprotein concentrations. You have not been told that in addition to cholesterol, fat is also essential for building hormones, essential for absorbing minerals from the intestines into our bloodstream, essential for the binding of these minerals into the bones and teeth, essential for energy production in every cell of our body.

Furthermore, you have not been told that saturated fats like those found in animal products and coconut oil are molecularly stable, whereas unsaturated and particularly polyunsaturated oils such as those that make up all vegetable oils are molecularly unstable, some more than others, for the double bonds between carbon atoms in the chain that forms the fat molecule are weak and readily broken to permit some other unstable molecule seeking a free electron to attach in order to make the final molecular configuration stable. But that those unstable compounds are actually scavenging around for any electron to bind to, and unfortunately most of the time if not always, these free-radicals will attach themselves to healthy tissue without proper enzymatic action to guide them in the proper place and position, thus damaging our tissues.

In fact, you have not been told that all large studies that have been conducted to evaluate the “health-promoting” properties of polyunsaturated fats have not only failed to do so, but instead have shown that the more polyunsaturated oils we consume, the more atherosclerotic plaques develop in our arteries, and therefore the more likely we are to suffer a heart attack or stroke. And that on the contrary, the more saturated fats we consume, the less plaques we have, and consequently, the less likely we are to have a heart attack or a stroke (see any of the books about cholesterol in Further readings).

You have not been told, that for millions of years our species has evolved consuming most of its calories in the form of saturated fats from meat and animal products—in some cases exclusively from these, from coconut and palm oil (where these grow), and to a much lesser extent from polyunsaturated fats, and this only in whole foods such as fish, nuts and seeds—never concentrated into vegetable oils.

Unfortunately—and indeed very sadly—you have not been told that we were never meant to eat simple or starchy carbohydrates: that eating such carbohydrates always triggers the pancreas to secrete insulin in order to clear the bloodstream of the damaging glucose in circulation, that chronically elevated glucose levels lead to chronically elevated insulin levels that in turn lead to insulin resistance—first in our muscles, then in our liver, and finally in our fat cells—which leads to type II diabetes, to heart disease from the buildup of plaque in the coronary arteries and vessels, and to Alzheimer’s and cognitive degradation from the buildup of plaque in the cerebral arteries and vessels.

Unfortunately—and indeed very sadly—you have not been told and have not considered that all the multitude of chemicals and heavy metals that we are exposed to in the medications we take, in the air we breathe, in the water we drink, in the food we eat, in the soaps and shampoos we use, and in the household products we employ to keep our house sparkling clean and bacteria-free, accumulate in our bodies. They accumulate in our fat cells, in our tissues, in our organs, in our brains. They burden, disrupt and damage our digestive system, our immune system, our hormonal system, our organs, tissues and cells. Sometimes they reach such concentrations that we become gravely ill, but none of the doctors we visit in seeking a solution and relief understand why. Most often, however, we don’t get gravely ill but instead start developing different kinds of little problems: we get colds more often and take longer to recover, we get mild but regular digestive upsets that we can’t explain and that seem to get worse with time, we get headaches and have trouble sleeping, we feel depressed, tired, alone, helpless, not acutely but enough to disturb us enough that we notice it.

Finally, and maybe most importantly, you have not been told how truly essential vitamin B12 really is, but how, for a variety of different reasons, blood concentrations B12 decrease with age, and eventually dwindle to very low levels. That B12 is essential most crucially to preserve the myelin sheath that covers all of our nerves healthy, and thus crucially important for everything that takes place throughout the nervous system, which means, everything in the body and brain. Levels of B12 should never go below 450 pg/ml, and ideally should be maintained at 800 pg/ml throughout life, from childhood to old age hood.

Can we do anything about all this?

The most fundamental point to understand is that everything about your health depends on the state of health of your digestive system. All absorption of nutrients and elimination of waste happens in the digestive system. Since our health depends on proper absorption and efficient elimination, the digestive system should be our first as well as our main concern.

The first step is to rebuild and establish a healthy intestinal flora of beneficial bacteria (breakdown and absorption), and at the same time begin to detoxify the body and clean out the intestines (elimination). This is done by taking high quality probiotics to supply beneficial bacteria on a daily basis, high quality chlorella to both supply a lot of micronutrients and pull out heavy metals, and water-soluble fibre like psyllium husks to clean out the intestines by pushing out toxins and waste products. If you are not already taking these, read Probiotics, chlorella and psyllium husks.

The second step is by far the most important, and in fact, crucial dietary change necessary to achieve optimal metabolic health. It is to eliminate simple and starchy carbohydrates from you diet, and replace them with more raw vegetables—especially green and leafy salads and colourful vegetables such as red and yellow peppers, more nuts and seeds—especially raw and soaked, more good and efficiently absorbed protein—especially eggs, fish and raw cheeses, and much more saturated fats—especially coconut oil (at least 3 tablespoons per day) and butter. Doing this is  essential for the systemic detoxification, rebuilding and then maintaining a healthy digestive system. Everything should be organic: you obviously don’t want to be adding to your toxic load while trying to detoxify.

And the third step is to supplement our now-excellent, health-promoting diet with a few essential and very important nutrients that are, for most of us, difficult to obtain. The only such supplements that I believe to be essential, and that my family and I take daily, are: Vitamin B12 and vitamin D3—the most important supplements to take for overall health, but in which we are almost all deficient; Krill oil—a high-quality, animal-based omega-3 fat with its own natural anti-oxidants, highly absorbable, and particularly important for proper brain function; Ubiquinol—the reduced and thus useable form of coenzyme Q10, critical for cellular energy production, and a powerful lipid-soluble anti-oxidant that protects our cells from oxidative damage, but both of whose synthesis as CoQ10 and conversion from CoQ10 to ubiquinol drop dramatically after about age 30-40; Vitamin K2—essential for healthy bones but very hard to get other than from fermented foods, which we typically eat little of.

In addition to these, we usually always take Astaxanthin and turmeric—very powerful antioxidants with amazing general and specific anti-ageing health benefits, and also sometimes take a whole-foods-multi—basically dehydrated vegetables and berries made into a powder and compressed into a pill for extra micronutrients. (You can read about all of these supplements on Wikipedia or any other page you will find by doing an internet search.)

I tend to buy our supplements from Dr Joseph Mercola, (whose website also provides a lot of info about these and other supplements, as well as about a multitude of other health-related issues and conditions), because I trust that his are among if not the best on the market: there’s really no point in buying cheap supplements at the pharmacy, and risking doing yourself more harm than good, as would happen with a rancid omega-3 supplement, or a synthetic Vitamin D, for example.

Staying healthy and lucid is, in reality, quite easy and simple. Unfortunately, most of us, including, and maybe especially our medical doctors, just don’t know how. And so, medical diagnostic and high-tech treatment technologies continue to improve and develop, and medical expenditures continue to rise throughout the modern world, but we are sicker than ever: more obesity, more diabetes, more strokes, more heart attacks, more cancers, more Alzheimer’s, more leaky guts, more ulcers, more liver failures, more kidney failures, and on and on. There is more disease, more pain, more suffering and more premature deaths. And all of it is completely unnecessary and avoidable by such simple and inexpensive means as those outlined herein. The only critical point is that only you can do it; nobody else can do it for you.

When you eliminate insulin-stimulating carbohydrates

Eliminating insulin-stimulating carbohydrates will have a profound effect on your health. What are insulin-stimualing carbohydrates? All simple sugars: white sugar, brown sugar, unrefined sugar, dehydrated cane sugar juice, coconut sugar, honey, molasses, corn syrup, agave syrup, fructose, and also fruit whose calories are typically half glucose half fructose. And all starchy carbohydrates: potatoes, rice, bread, pasta, all grain products and whole grains alike. That’s quite a lot of things we tend to eat, isn’t it? But the truth is that We were never meant to eat simple or starchy carbohydrates in the first place. And the fact that we do is enough to explain why we are all so fat and so sick.

The first and most noticeable immediate effect will be deep detoxification by starving off and killing of the colonies of pathogenic bacteria and fungi in the intestines, all of which live off simple sugars supplied either by your eating of refined carbohydrates or the breakdown of starches to glucose. All these bad bacteria will starve and die, which will temporarily increase the toxins that need to be eliminated from the body. For this reason it is very important to drink plenty of water (see Water, ageing and disease), on an empty stomach, and preferably about 30 minutes before meals (see Why we should drink water before meals) together with probiotics and chlorella supplements, as well as plenty of unrefined sea or rock salt because the body excretes more sodium when it is burning fat. You may very well not feel so good for the first few days or maybe even the first couple of weeks depending on the state of toxicity of your body and its ability to detoxify. But once past this initial detox phase, you will feel great—really great.

The second most noticeable effect will be the transition from using glucose as the primary cellular fuel to using fat instead. As glucose concentrations will fall, so will insulin concentrations. At the beginning, your body is unable to burn fat because it hasn’t had to for a long time. Instead, it will try to manufacture more glucose in the liver to sustain its energy needs. When this source runs dry, the body, now desperate for sugar because still unable to tap into the plentiful fat stores throughout, will turn to muscle tissue, and break down the proteins to manufacture glucose. This is what insulin resistance, even in the mildest of forms, leads to: more fat storage, less fat burning, and breakdown of muscle tissue whenever glucose concentrations drop. What varies depending on the level of insulin resistance is the pace at which fat is stored, the relative difficulty with which fat is burnt, and the speed at which muscle tissue is broken down.

Fortunately, the body is truly amazing, and although you will have periods, some short and some longer, during which you feel weak, tired and sleepy, within days the metabolism will begin to make the switch to fat-burning as the main source of cellular fuel and energy. Then, you will start to melt all of the excess fat that has been accumulating both on the surface of your body (the visible bulges under your skin), as well as the fat that has been accumulating internally between and around all of your organs, especially in the abdominal cavity, but also around tendons and ligaments, and even within the tissues or your liver and heart, and in between muscle fibres—we all know the difference between lean meat and fatty meat, and will have had or at least heard of the french delicatessen “foie gras” (fat liver).

I, for example, a lean 35 year-old athlete who had always exercised extensively through a typically quite intense training programme in endurance, speed and strength since I was 12 (first running, then cycling, then both), with a peak during the university years, when I competed quite seriously first in cycling (road), then in duathlon (run, bike, run), and then cycling off-road, and another during my PhD, when I trained and competed running, with the most worthy achievements being the running of the Mont Saint-Michel marathon in 2:58, but training more or less steadily throughout my life, found the transition from glucose to fat-burning very quick and easy. That was about 4 years ago, and small details of momentary sensations tend to slip out of memory over such periods, but of course I had a few headaches and foul smelling stools. But within days, I had more energy, more endurance and better, longer-sustained concentration, and it’s been getting better ever since! None of my body measurements changed significantly: I was always pretty lean and my clothes didn’t fit differently. However, I lost 4 kilos (9 pounds): my weight went from of 61 to 57 kg, and has remained thus ever since, without any effort, and without hunger. Consequently, most of these 4 kg were surely in part sub-cutaneous, but necessarily in great part internal fat stores: intra-abdominal (between organs), visceral (within organs like the liver and heart), and intra-muscular.

Averagely overweight people typically lose a lot more fat than this. Like a friend who followed my advice closely, and lost more than 25 kilos (55 pounds) in about a year, without hunger. And she is still melting fat reserves that had been accumulating and that she had been carrying around for years. Beyond a certain threshold, as the body gets closer to its ideal weight and composition, the fat reserves naturally begin to melt a little slower every day. Nonetheless, it will continue until there is only the necessary reserves for optimal metabolic function—and that’s not very much fat.

There are thousands of examples such as this one, but this is not the point I want to make. The loss of fat is a trivial consequence of the body’s hormonal and metabolic recovery. It is everything else that happens to the glands, the hormones, the brain, the digestive system, the immune system, the cardio-vascular system, and all other systems, allowing more efficiently and better functioning, that is really important. You should always keep that in mind: it is not about getting thin, it is about getting healthy.

When fat-burning kicks in and especially when it kicks into high gear, all the toxins—heavy metals like mercury and chemicals of various kinds—that have been accumulating in your tissues will be released as the fat cells open up to free these energy reserves. It is crucial to drink a lot of water, especially first thing in the morning, to take plenty of unrefined sea salt to balance the increased need for and usage of electrolytes in elimination through the urine, and take plenty of chlorella throughout the day for it to bind to the metals and toxins, and excrete them from the body.

The third most noticeable effect of eliminating insulin-stimuating carbohydrates will be the gradual extraction and excretion of uric acid from all the soft tissues and organs. Since metabolising simple and starchy carbohydrates leads to acid formation, and that our kidneys—our primary blood filtration and thus acid-removing organ—never developed to handle the huge quantities of acid produced by a diet based on carbohydrates, it tries to filter it out of the blood, but simply cannot take it all out. To make matters worse, 90% of us are chronically dehydrated (see Water, ageing and disease). This not only prevents the proper dilution of the uric acid from the blood and its transfer to the urine, but it also severally stresses the kidneys that are continuously trying to filter this and other metabolic wastes from the poorly hydrated, and thus excessively thick and viscous blood, extracting what liquid they can from it to actually produce enough urine to excrete the wastes out of the body.

To make matter even worse, for years we have been told to avoid salt, and supplement with calcium. As a consequence, 90% of us are not only deficient in most essential minerals (see Minerals, bones, calcium and heart attacks), but also in sodium—probably the most important element for proper health and kidney function, and on the contrary, we are totally over-calcified. All of this makes both calcium and acid accumulate not just in our kidneys to the point of forming “stones” (about 80% of them are calcium deposits with crystallised uric acid seeds and 10% pure uric acid), but everywhere in our body, making all tissues gradually stiffer, from arteries and veins to muscles, tendons and ligaments. What a nightmare! And what a sad state of affairs it is when we realise that this is a highly accurate description of what happens to most of us, day after day, and year after year until our untimely and inevitably premature death.

The last straw is that we are all terribly deficient in magnesium, scarcely found in our soils and therefore in our foods, and this leads to severe problems over time. If you didn’t know or need convincing, read Why you should start taking magnesium today.

What do we eat when we eliminate what currently constitutes between 50 and 70 percent of our daily calories? I’ve written up some general guidelines with brief explanations in What to eat: Four basic rules. And here are some examples of daily meal plans: A simple meal plan for my friend Cristian and Vibrant health and long life.

We were never meant to eat simple or starchy carbohydrates

The transition between hunting-gathering and farming took place over a period of about 1000 years between 11000 and 10000 years ago in the Fertile Crescent, a crescent-like shape of land that stretches across parts of Israel, Lebanon, Jordan, Syria, Iran and Iraq. The first people to settle were hunter-gatherers that built villages in places they found provided enough food to sustain them without having to move around. At first, these were “seasonal” villages located in different areas, to which they returned in a seasonal cycle. Finding ways to store the grain from the large seeded grasses like barley and emmer wheat growing wild but in large quantities, allowed them to settle permanently. This most likely led to a rapid growth of the population, that was matched with a proportionally rapid growth in the demand for food. The response was the development of agriculture.

The gradual decimation of the wild game over the course of about 2000 years led to the domestication of the most easily domesticable, large mammals to inhabit the region, the sheep, goat and pig, all about 8000 years ago, followed by the cow about 6000 years ago. It is very interesting and important to point out, from an anthropological point of view, that the Fertile Crescent—the seat of civilisation—is the region in the world where there were the greatest number of large-seeded grasses, as well as the greatest number of large, easily domesticable animals, by far.

The cultivation of cereal crops allowed our ancestors, some 10000 years ago, to have, for the first time in our evolutionary history, enough spare time to develop tools and technologies, as well as arts and music. For the first time in evolutionary history, a handful of people could sow, tend to, and harvest enough cereal grain to feed hundreds or even thousands of people who were, therefore, free to do a multitude of other things. Without agriculture and this shift from the hunter-gatherer lifestyle of spending most of our waking hours hunting and rummaging around looking for food, we would not have developed much of anything because we simply never would have had the time to do so.

Now, although it is well known to most anthropologists, it is not a well appreciated fact that the cultivation and eating of cereal crops as an important source of calories, is possibly the most negatively impacting evolutionary mistake to have been made in regards to the health and robustness of our species as a whole. There was, indeed, plenty of free time, and we did develop technologies extremely quickly considering how slowly things had changed before then. But the price to pay was high.

Within as little as one or two generations, our powerful stature shrank markedly, our strong teeth rotted, our massive bones became thin and brittle, our thick hair grew thin and fell out at an early age. In fact, evidence indicates that while our hunter-gatherer ancestors were tall, strong, robust, with hard teeth and bones, and apparently healthy to their death—usually of a violent nature instead of progressive degradation through “ageing” as later became the norm, our oldest cereal-eating ancestors in contrast, were the exact opposite: small, weak, fragile, with rotten teeth, and advanced osteoporosis in their bones at the time of their death in their early 50’s. (For a lot more details about all the points discussed up to here, I strongly recommend Jared Diamond’s fascinating books: The Third Chimpanzee; Guns, Germs and Steel; and Collapse).

Today, at the beginning of the 21st century some 10000 years later, we know exactly why we were never meant to consume carbohydrates on a regular basis, let alone in large quantities as we do today, such that they provide a significant part of our daily calories—sometimes even the majority! We know exactly why because we have pretty clearly understood the primary effect of phytic acids or phytates, the importance of dietary fats, and the insulin mechanism.

Phytates are compounds that exist in all grains and legumes—where they are found in the greatest concentration—as well as in all nuts and seeds. Some animals like rats, for example, have evolved the necessary digestive mechanisms to break down phytates, but humans have not. The consequence is these bind to minerals in the gut and in so doing prevent their absorption into the bloodstream. The regular consumption of grains and legumes—and we believe that many of our first agrarian ancestors lived almost exclusively from grains—leads to severe mineral deficiencies that result in demineralisation of the teeth and bones, exactly as is seen in the remains of these ancestors.

Moreover, any diet consisting primarily of grains (and legumes) as was theirs, will also inevitably be extremely deficient in fat, that is now know to be essential for the proper function of every cell, tissue and organ in the body (especially the brain), but also crucial in the absorption of minerals. So, the combination of a high concentration of phytates together with an almost complete absence of fat, made for an extremely effective demineralisation, which is indeed seen in the smaller statures, weakened bones and teeth, and considerably shortened lifespan of our agrarian ancestors. This obviously still applies today: the more phytates, the faster the demineralisation; and the less fat; the faster the demineralisation.

Finally, insulin is a hormone secreted by the pancreas. There is always a certain concentration of glucose in the blood, and there is also always a certain concentration of insulin. If there isn’t a major metabolic disorder, then the higher the glucose concentration, the higher the insulin concentration. And conversely, the lower the glucose concentration, the lower the insulin concentration. But since the body is programmed to always keep glucose concentrations to a minimum, as soon as there is a simple carbohydrate in our mouth, insulin is secreted into the bloodstream. As the glucose—either from the simple carbohydrates or from the breakdown of starches—enters the bloodstream through the intestinal wall, and as its concentration continues to rise, the pancreas continues to secrete insulin to match the concentration of glucose; but always a little more, just to be on the safe side.

Why? If glucose were good for us, then why should we have this highly sensitive mechanism to always try to get rid of it?

Insulin’s primary role is storage of “excess” nutrients, and regulation of fat storage and fat burning: when insulin is high, there is fat storage; when insulin is low, there is fat burning. It’s very simple. This, in turn, means that insulin is the primary regulator of energy balance, and therefore of metabolism. From an evolutionary perspective, the importance of insulin is perfectly clear. Firstly, it is a mechanism that is common to almost if not all living creatures, from the simplest to the most complex, because all living creatures depend for their survival on a mechanism that allows them to store nutrients when they are available for consumption but not needed by their metabolism, in order to live through periods where food is not available. This is why the role of insulin is so fundamental and why it is a master hormone around which most others adjust themselves. But when glucose levels are higher than a minimum functional threshold, what insulin is trying to do, in fact, is to clear away the glucose circulating in our bloodstream.

Why? Because the body simply does not want large amounts of glucose in circulation. In fact, it wants blood glucose to be low, very low, as low as possible. And beyond this very low threshold of glucose concentration between 60 and 80 mg/dl, it always tries to store it away, to clear it from the bloodstream, to make it go away. It tries to store as much as possible in the muscles and the liver as glycogen, and converts the rest to fat stored away in fat cells. That the body does not want glucose in circulation is most certainly related to the fact that the insulin mechanism even exists: very small amounts of glucose in the bloodstream is essential for life, but large amounts of glucose in the bloodstream is toxic. And all simple and starchy carbohydrates stimulate the secretion of insulin from the pancreas.

Keep in mind that the presence of insulin promotes the storage of glucose, but also of proteins as well as fats. Once more, its role is to store away and deplete the “excess” nutrients in the bloodstream for later times of food scarcity. Once the insulin molecule has delivered its load (glucose, protein or fat) through the receptor on the cell, it can either be released back into circulation or degraded by the cell. Degradation of circulating insulin is done by the liver and kidneys, and a single molecule will circulate for about 1 hour from the time it was released into the bloodstream by the pancreas until it is broken down.

It is important to add that stress stimulates the secretion of stress hormones that in turn stimulates the release from and production of glucose by the liver, just in case we need to sprint or jump on someone to save ourselves. Obviously, the presence of glucose—now not from ingested carbohydrates but from the liver itself—will trigger the secretion of insulin in exactly the same way as if we had eaten sugar. This means that stress mimics the physiological effects of a high sugar diet. And that’s not good. In fact, it’s pretty bad.

Chronically elevated glucose levels lead to chronically elevated insulin levels. And this is much worse. Like for any kind of messenger mechanism—as is insulin, if there are too many messengers repeating the same message over and over again, very soon they are not heard well because their efforts at passing on the message becomes more like background noise. Frustrated that they are not taken seriously, the messengers seek reinforcements in numbers to be able to pass on their message more forcefully. This, however, leads to even more annoyance on the part of the listeners—the message recipients—that now start to simply ignore the message and the messengers. This process continues to gradually escalate up to the point where the terrain is completely flooded by messengers yelling the same thing, but there is no one at all that is listening because they have insulated their windows and doors, and closed them tightly shut.

Here, the messengers are the insulin hormone molecules secreted by the pancreas and coursing throughout the body in our veins and arteries; the message recipients are our cells: muscle tissue, liver and fat cells; and the message itself is “Take this sugar from the bloodstream, and store it away. We don’t want this stuff circulating around.” The desensitisation—the not-listening—to different, progressively higher degrees with time, is called insulin resistance. Finally, the complete ignoring by the cells of the message and the messengers is called type II diabetes.

Furthermore, insulin resistance—not in the muscle, liver and fats cells, but in the brain cells—clearly leads to neurological degradation identified as cognitive impairment, dementia, Alzheimer’s or whatever other terms are used. Because beyond the fact that type II diabetes and Alzheimer’s disease are both increasing together at an alarming rate in the US and other western countries, and beyond the fact that diabetics are at least twice as likely to develop Alzheimer’s compared to non-diabetics, the basic condition of insulin resistance inevitably leads to chronically elevated glucose concentrations simply because the cells do not allow the glucose to enter. And it is well known that glucose in the blood simply and straight forwardly damages to the lining of the blood vessels, which then leads to plaque formation—the body’s repair mechanism for the damaged cells underneath. Thus, as are the coronary arteries of advanced atherosclerotic heart disease sufferers (and diabetics): riddled with plaques, so are the arteries and blood vessels in the brains of Alzheimer’s sufferers (and diabetics).

Now, although many claim that these and other issues related to the development of Alzheimer’s disease and other kinds of neurological degradation are still relatively poorly understood, as far as I’m concerned, it’s all the evidence I need: Do you want the vessels supplying blood to the brain fill up with plaque in response to the damage caused by glucose circulating in the bloodstream? Do you want the coronary arteries fill up with plaque in response from the damage caused by glucose circulating in the bloodstream? I certainly don’t. How could anyone?

What do we need to do? Very simple: just eliminate  simple and starchy carbohydrates from the diet. Concentrate on eating a lot of green vegetables, tons of green leafy salad greens; plenty of fat from coconut milk, coconut oil, nuts and seed of all kinds; and a little animal protein from eggs, raw cheese, wild fish and meat (if you chose to do so). Blood sugar will drop to its minimum, insulin will follow suit, and the body’s own repair and maintenance mechanisms will clear out the plaques, repair damaged tissues, degraded unneeded scar tissues and small tumours and recycle these proteins into useful muscle tissue, and many, many more amazing things will happen to the body that it will gradually look and feel younger and stronger as time passes. Sounds too good to be true? Just try it, and you’ll see for yourself. I guarantee it.

What about concentration

Concentration is a complex topic. As with many other things, because we use a single word for it, we can be tricked into believing that it is, in fact, one thing even though it is not. In addition to that, different people will likely mean different things when they use the term “concentration”.

For me, “concentration” means focusing attention onto something, and in the process, excluding as much as we can of everything else that is going on in the field of present experience, deeming them distractions. To concentrate on trying to hear a particular sound, for example, a very faint sound way off in the distance, implies directing our attention towards it with all our mental might. And somehow by doing this it is implied that we have to exclude everything else that is happening, and the better we can exclude everything else the more concentrated we can be.

But focused attention tends to be very fast moving, spontaneously jumping from this thing to that thing to the other thing, continuously and restlessly. This happens so quickly and so continuously that most of us hardly notice it at all. Therefore concentrating requires a great deal of effort and energy. This is why it is so exhausting, and this is also why it cannot possibly be sustained for very long. In fact, there may come a time when we notice that concentrating is becoming harder and harder, or even that we are simply unable to do it for any length of time. And then we start to worry because we feel that we cannot get anything done as we are totally distracted and scattered, continuously and incessantly.

Naturally, our first strategy should be to minimise our own stimulating of this jumping from one thing to another by restricting ourselves to doing the task we have at hand whole heartedly, without interrupting ourselves every few minutes or even seconds to check this last email that just came in to our inbox, or lookup something with Google. For most of us, this kind of scattered multi-tasking will only exacerbate the scattering of attention and gradually prevent us from doing any one thing for longer than a few minutes, if that. To minimise mental jumpiness we should minimise jumpiness in the way we work and function. Just turn off that email notifier, close your inbox, close your web browser, and work on your document or the problem you are trying to solve.

Beyond this basic strategy of minimising scattering behaviours, what if instead of concentrating we simply paid attention. The essential difference is that although paying attention does require a certain kind of effort, it does not require excluding anything at all, it does not require the straining effort of continuously pushing things away to re-focus attention. In fact, the more facets of our immediate experience we include in paying attention—the more we open our attention—the more we can indeed pay close attention to what we are attending to. Since we tend to focus on the thoughts, images, memories and run-on stories and commentaries that we continuously tell ourselves throughout the day and night, since we tend to live in our head, looking out through the eyes as if they were our windows onto this world outside that surrounds and often threatens us in various ways, the means to bring in balance is to spread attention to the body.

Feel the breath in the belly filling our inner cavity with air and keeping us alive in this very moment, and feel it in the belly with the belly, not just once, but breath after breath after breath. Feel the feet on the floor with the feet and toes, whether we are sitting, standing or walking: feeling the weight of the body rolling from the heel to the front of the foot, first on the right foot, then on the left, step after step. Feel the hands holding a cold glass of water, holding a hot cut of tea, holding a book, holding a baby: feeling the weight, the texture, the temperature. Feeling the water running on the skin when we wash the hands over the sink, the body in the shower. Really feel the body with the body. Don’t talk about it to yourself, don’t comment: just feel it.

Doing this—feeling the life of this body with this living body—will gradually and naturally bring our attention into balance, allowing us to function more freely, more easily, and more efficiently, no matter what we are doing. However, on the most basic level, our emotions, moods, tendencies, states and thus the general configurations of attention, are regulated by hormones: messengers coursing through the blood carrying all sorts of signals to organs and tissues. And as it cannot possibly be otherwise because the same blood circulates everywhere, all of these hormones have some influence on our brain. Therefore, for the brain to function properly, and our moods to be stable, and our attitude positive, there is no other way than to re-establish and maintain proper hormonal balance. Hormones, in turn, are primarily regulated by what we eat and what we drink: hormonal balance is rooted in our diet.

One of, if not the most important hormone—the one that has both the greatest direct and indirect influence on the other hormones—is insulin. For this reason, the only way to establish and maintain proper hormonal balance is to make sure that insulin is balanced—that it is by natural means as low as possible.  When insulin is low, everything else naturally falls into place: appetite, energy levels, mood, mental function and sleep. Naturally, it should be needless to say that all chemical stimulants, be it coffee, alcohol, cigarettes or drugs (prescription or not) should be eliminated, as these are all potent hormonal disruptors.

Fortunately, it is very easy to lower insulin levels and keep them low: as insulin levels mirror blood glucose levels, we need simply eliminate refined and starchy carbohydrates from your diet. Unfortunately, for most of us today this is not so easy because we are plainly addicted to carbohydrates.

I use “addicted” with the same strong, negative connotation as it is used in the context of drug use, because it really is so in the sense that our entire hormonal system is regulated by glucose levels and insulin, and although we may think somewhat differently of the powerful urge to smoke a cigarette or have a cup of coffee, an intense craving for chocolate or plain old hunger, all of these are regulated by our hormones whose overall profile is shaped, (distorted rather), by the presence of sugar and insulin. So, we do need to get over our addition to carbohydrates in order to function smoothly and efficiently as stable and balanced individuals. This is done by gradually reducing refined and starchy carbs as much as possible. And there is no minimum: the less of them we consume, the better off we’ll be.

Eliminating these carbohydrates from our diet will most likely lead to the elimination of at least half, if not three quarters of our daily calories. Considering the multitude of detrimental effects carbs have on our health—on our body and mind—this is indeed quite sad, but for most of us it is true. So what do we replace these empty calories with? Fats, and mineral and enzyme rich foods.

Fat is not only the constituent of every membrane of every cell in our body, but it is also the cellular fuel of choice. Therefore, fat should rightly be our main source of calories—at least 50% of them (I personally aim for 70% of my calories from fat). What kinds of fats? Lots of natural, unprocessed, chemically stable saturated fats from coconut oil, butter, eggs and cheese—preferably all organic to minimise the ingestion of toxic substances; monounsaturated fats from olive oil for salad dressings—choose a flavourful, unfiltered, fresh and cold pressed oil; polyunsaturated plant-based omega-3, omega-6 and omega-9 fats with Vitamin E complex from many different kinds of whole, raw nuts and seeds every day—buy only the best and freshest organic or wild harvested nuts and seeds; and polyunsaturated animal-based omega-3 fats with the vital Vitamins A and D from eggs, fish (for those who eat some), and krill oil supplements—these are absolutely essential for optimal health. Omega-3 fats are really important but needed only in small amounts. They should also be consumed in small amounts because they are very easily oxidised into free radicals. The animal omega-3 fats are particularly important for proper brain function.

Cholesterol is essential, especially for optimal brain and nerve function because synapses—the connections that allow electrical impulses to travel from one nerve cell to another—are almost entirely made of cholesterol. Moreover, most hormones are also made from it as cholesterol is used as their building block. Therefore, we must consume plenty of cholesterol-rich foods such as eggs, as well as plenty of cholesterol synthesis-promoting foods such as the good saturated fats mentioned above.

Minerals basically make up the solids of the body, and in this respect, it is vital to replenish them on a daily basis through the foods we eat: nuts, seeds and vegetables, (sea vegetable are the richest of all). And for vegetables, the greener and darker the better. Furthermore, eaten raw these nuts, seeds and vegetables provide plenty of enzymes and anti-oxidants that offer a wide spectrum of remarkable health benefits. It is crucial to keep in mind that all minerals and anti-oxidants are much better absorbed from the small intestine into the bloodstream when there is plenty of fat in the digestive system. In fact, in some cases, the absence of fat prevents the absorption of both minerals and anti-oxidants. I have not included fruit in this discussion because fruits are basically just simple sugars: glucose and fructose, and offer very little in terms of minerals, and phytonutrients compared to most vegetables. All berries, however, fresh or dried, are excellent as they are usually low in sugar, and often very high in anti-oxidant and healthful compounds.

Sometimes, allergies and toxicities such as heavy metal accumulation in the tissues, are at the root of what may appear to be either a mood or neurological disorder. The best way to detoxify and cleanse the body of heavy metals such as mercury is to take chlorella and spirulina supplements on a daily basis, on an empty stomach with plenty of water at least 30 minutes before meals. These have the ability to bind to heavy metals and flush them out of the body through the stools. And as for allergenic compounds, this needs to be investigated be each person individually.

Finally, water is vital for life and health. We must therefore have plenty of it, and drink on an empty stomach first thing in the morning and before meals.

There is no way to address what we may call “concentration problems” without addressing everything about what we eat and drink. Everything relating to brain function is also related to bodily functions and vice versa. Whether we like it or not, and whether we recognise it or not, this bodymind is whole, and mind and body are seamless. This is therefore how it must be taken care of and treated.