The Right Way to Think About Metabolism
One thing we need to clear up first is that your metabolism is not about calorie burning, built upon that old mindset of “calories in, calories out” (your metabolic rate being the “calories out” part).
Metabolism really refers to every single process that goes on in your body all day long including repairing cells, detoxifying, making hormones and building muscle. It’s not just about breaking things down or burning fat. That’s a gross oversimplification and leads us to say silly things like “I have a slow metabolism” in cases where we have difficulty losing weight.
It’s also less about calories than it is about nutrients – nutrients actually drive healthy metabolism. You can have all the calories in the world, but without nutrients, you’ll die.
Metabolism is about function, which includes all the chemical processes happening in our body that help us sustain life. Our liver has it’s own metabolism, our digestive tract, lungs, skin, etc.
Metabolism is influenced by all types of inputs, from your thoughts and belief systems to your sleep and diet. Everything in our inner and outer world has an impact on our body’s daily processes.
So, let’s abandon all notions that our metabolism is about calorie burning or something you have to push your body to do or something that is working against you.
The truth is that your body is always working in your favor (even in illness), operating as efficiently as possible to meet your needs and is way more complex than we can ever pretend to understand.
This discussion will give you a clue into the major way in which we disrupt our metabolism (different from slowing it). Could one argue that there are parts of your metabolism that have slowed? Yes. But, really, the priorities have just shifted and your body may be doing less of what you think it should be doing, and more of what it actually needs to be doing in order to keep you safe (more on that in a minute).
The Key Metabolism Disruptor: Insulin Resistance
Here’s a quick overview on what insulin is and how it works:
When you consume food, especially food containing carbohydrates, your body responds by producing insulin, a hormone released from the pancreas. Insulin’s role in your metabolism is to get sugar (glucose) and nutrients into the cells. Insulin “unlocks” the cell, allowing glucose in. This lowers your blood sugar because now the sugar is out of the bloodstream and in various cells for use. These include your liver, heart, brain, fat, muscle, etc. Insulin has a very important role in helping to build muscle and feed your brain and body. There are always low levels of insulin in your bloodstream, the amount increases significantly once the pancreas detects an influx of glucose into the bloodstream.
Below: the large blob represents a cell. The hormone insulin (yellow) fits like a key into a receptor (blue), which sets off a complex chain of events that ultimately leads to the movement of lots of channels (green) from inside the cell to the surface of the cell, allowing glucose and nutrients to enter.
The problem occurs when the cells become resistant to insulin, which means they remove lots of their insulin receptors (blue) from the cell surface, so that insulin cannot open them up for sugar. Another thing that can happen is that insulin does unlock the cell, but enough channels (green) don’t show up on the surface or the ones that show up don’t work well. This leads to elevated blood sugars and a poorly nourished body. When you’re body is not getting nourished properly, your appetite and cravings increase.
Not only that, but because insulin responds to how much sugar and other nutrients are in the blood, if the sugar levels don’t go down, the pancreas just releases more and more insulin.
So, now you’ve got high blood sugar AND high insulin levels – both in excess are very inflammatory and very damaging.
Too much INSULIN in your blood all on it’s own can lead to:
- High Cholesterol
- High Blood Pressure
- Fatty Liver
- Heart Disease
- Polycystic Ovarian Syndrome (PCOS) – cysts on the ovaries
Essentially, more and more research is showing that insulin resistance and elevated insulin levels (notice, I didn’t say elevated sugars) are at the root of most of our chronic metabolic conditions today, often called metabolic syndrome. Insulin resistance can result from elevated sugars, but it can also result from things that have nothing to do with diet. We’ll get to that.
Insulin resistance causes heart disease. Insulin resistance causes fatty liver. Insulin resistance causes Alzheimer’s, etc. in the majority of cases. There are other contributors, but rarely will you find any of the above conditions without insulin resistance as a major factor.
So, instead of thinking that obesity causes these conditions, realize that obesity is a symptom of insulin resistance just like the others. (1) And they all feed off of each other. For example, insulin resistance can cause high blood pressure and obesity. Then the obesity compounds the problem of high blood pressure.
We also know that insulin causes weight gain. That’s it’s job, to store things. And, diabetics taking insulin gain more weight. (2)
In essence, obesity is a hormonal problem, not a caloric problem. Hormonal imbalances lead to obesity, which creates more hormonal problems, driving people to eat more and exercise less. It’s all driven by hormones, insulin being a big one.
How Does This Happen?
This is complex, like most things when it comes to health, but I’d like to simplify it with one word: INFLAMMATION (notice, I didn’t just say diet or high sugar intake)
We’ll reduce the sources of inflammation to 4 major categories:
- Emotional Stress – oftentimes, we don’t think we have a lot of stress in our lives because we’re just used to it. Rushing around, staring at computer screens all day, holding onto to grudges, resentments, feelings of inadequacy, fear-based thinking, chronic worry, etc. Then there are the more acute stressful life events that knock us down for a period of time. These all add up. They increase stress hormones and inflammation. I have seen many clients who look very fit, eat a ridiculously healthy diet with hardly any fat mass who have insulin resistance driven by this one factor alone. Stress.
- Diet – deficiencies in certain nutrients like chromium, magnesium, B vitamins, omega-3 fats and many others will create a situation where the cell wall is not healthy enough to properly respond to insulin. Also, even if these nutrients are present, consuming inflammatory foods can be damaging to the cell walls. Remember that many of us have foods that inflame us that are otherwise considered healthy, like tomatoes, chocolate, certain fruits and vegetables. That’s why it’s important to work with someone who can do the appropriate testing to determine what your triggers may be. Of course, high sugar diets and diets too high in carbohydrates can drive this as well.
- Hidden stressors (infections within the gastro-intestinal tract, environmental toxins, etc) – this area is not discussed enough in the mainstream medical model, but is a common issue for many people and they just don’t know it. Whether it be an H.pylori infection or some other pathogen, there are many viruses, bacteria and fungi that can co-exist with us in a mutually beneficial or neutral way, but they can become harmful to us and inflammatory when our bodies are stressed. Then there are other pathogens that we don’t want in us at all. Stool testing can give you a good idea if this is something contributing to your health conditions. Environmental toxins are also a significant contributor, especially when it comes to activating genes that promote the development of insulin resistance. Generally, imbalances in your gut bacteria are also a HUGE contributor, hence why many people believe that all health (and disease) begins in the gut.
- Sleep – not getting enough sleep is a huge stress to the body, all on it’s own, even if you have all the other areas in balance. Your body repairs itself while you sleep, which is critical for balanced metabolism, appetite, brain function, etc. EVERYTHING goes wacky if you don’t get enough sleep, ideally 7-9hrs. Many people will benefit from shooting for 8-9hrs.
NOTE: You’ll see that diet is only one factor. You could be eating a low carbohydrate diet and still become insulin resistant because of the other stressors listed here. All of these really important factors deserve a blog of their own to help tease out what you can do to reverse insulin resistance, so look out for those.
In the meantime, know that when you have too much sugar in the blood as a result of insulin resistance that the safest thing for your body to do is to store the sugar as fat. And you have unlimited fat reserves. So, for those of you interested in weight loss, it’s important to look at weight gain as part of your body’s way of adapting to the environment in the bloodstream, protecting you from elevated blood sugar.
How Do You Know if You’re Insulin Resistant?
Keep in mind:
- You can be insulin resistant for years and never know it.
- You could be eating a very low carbohydrate diet and still become insulin resistant.
- You can be lean and feel otherwise healthy and have insulin resistance.
- You can have no family history of diabetes and not be diagnosed as diabetic and have insulin resistance.
- You can be athletic and active and have insulin resistance.
- Insulin resistance exists on a spectrum – you can be mildly insulin resistant and REALLY insulin resistant.
Here are some traditional indicators of insulin resistance:
Elevated Blood Pressure (>140/85) – if your levels are below this WITH medication, that does not mean you don’t have high blood pressure, you’re just suppressing it. So, if you’re on blood pressure medications, you have high blood pressure.
Cholesterol – increased large VLDL, increased small LDL and decreased large HDL – you’ll need to ask your doctor to perform this more advanced cholesterol panel, such as an NMRLipoProfile, the traditional cholesterol panel that focuses on your total number is pretty meaningless.
Elevated triglycerides (TG) (>150, less than 100 is fantastic) – this is the most valuable indicator on your traditional test done by a doctor. You can go a step further and look at the TG/HDL ratio. The lower the ratio, the lower your risk of heart disease and many of the complications listed above.
Elevated Fasting Blood Glucose (>100 mg/dl) – this is part of the fasting lab that you do at your annual physical. You can also check your fasting levels at home with a glucometer. An even more telling test is a post-meal blood sugar, which you can read about here.
Elevated Fasting Insulin (~5 mg/dl) – this test is not typically done at your doctor’s office, though you can ask if they offer it. Many don’t do these tests due to cost. Rising levels of fasting insulin usually occur well before your fasting blood sugar does and can help you catch insulin resistance early. Otherwise, use the post-meal blood sugar as your best at-home assessment, again, outlined here.
BMI (>30) – definitely a flawed system and not typically a good assessment of fat mass, however numbers greater than 30 often indicate a problem. Note: about 40% of normal weight individuals can be insulin resistant as well. I’m definitely not singling out overweight or obese individuals, however, this altered metabolism is statistically present in about 80% of people with increased fat mass.
Waist Circumference (> 35 inches for women, > 40 inches for men) – this is a better measure than BMI. Carrying more weight around the waist (measure at the belly button) is an indicator of insulin resistance.
Waist to Hip Ratio (> 0.8) – many people are unaware that people who are lean can also suffer the problems of out of control inflammation, elevated blood sugars and elevated insulin. I like this measurement because someone who is lean with insulin resistance may not have the waist circumference listed above but they’re waist to hip ratio is indicative of insulin resistance. What this means is that they have a wider waist than they do hips (measured at the widest part of the hips).
Other signs and symptoms:
Fatty liver – elevated liver enzymes are a clue (AST/ALT) or your doctor may perform an ultrasound or MRI to detect fat levels in the liver; this is grossly underdiagnosed as many people don’t have symptoms at first, but this condition is very, very common.
Gout – a type of arthritis that is really a metabolic disorder involving insulin resistance
Skin tags – you can see pictures and info here
Hirsutism – male pattern hair growth on women (face, chest or back), most typically a result of PCOS, which is caused by insulin resistance.
Acanthosis Nigricans – dark, velvety patches of skin found around the neck, armpits or groin.
So, you can see that there are many signs and symptoms that may indicate disorders in healthy metabolism. This is a complex problem and one that affects over half of the population if you add up people suffering from diabetes, heart disease, fatty liver and all the other issues stemming from this one powerful hormone: insulin.
What Can You Do About It?
Tons! This is a completely preventable problem. The next few blog posts will take each of the 4 sources of stress and inflammation individually and what you can do to improve them, so make sure you’re signed up for the newsletter to get each of those in your inbox.
Please share this with your loved ones and get them excited to start on a path of prevention and reversal of their conditions. All they need are the right tools, which I’ll be sharing with you over the coming weeks.
Questions or comments? Leave them below or contact me directly. I look forward to hearing from you!