Why Are We Fat?

This is a topic I've discussed before, but it's so important that it bears repeating.  The Standard American Diet is killing us.  In 2019, a staggering 75% of the American population are either overweight (BMI > 25) or obese (BMI > 30), projected to be 85% by the year 2030.  If you are overweight or obese, you are almost certainly insulin resistant.  Other risk factors for metabolic syndrome, which is derived from insulin resistance, include abdominal fat, high blood pressure, high blood sugar, low HDL cholesterol, or high triglyceride levels.  Insulin is the body's "fat storage" hormone and the higher your insulin levels, the fatter you will be.  The "Standard American Diet" has produced this epidemic over the past several decades.  In 1954, only 15% of the American population was overweight or obese.  Insulin resistance leads to pre-diabetes which leads to type 2 diabetes.  As of 2019, 60% of Americans are either diabetic, or pre-diabetic.  This does not have to do with exercise or changes in behavior, rather it has everything to do with what we eat, and when we eat.  This all started when in 1955 Dr. Ancel Keys announced his "lipid heart disease hypothesis" where he proposed that fat and cholesterol were to blame for heart disease.  Unfortunately for us and for the "Standard American Diet" that was patterned on his proclamation, he was completely wrong.  The American government has recommended and subsidized a low-fat, low-cholesterol diet for decades based on this wrongheaded hypothesis which has resulted in an epidemic of obesity, diabetes, heart disease, Alzheimers, cancer, and other diseases, which used to be far less common.

Interestingly, exercise plays almost no role in gaining or losing weight.  Exercise is beneficial for your body and your mind in numerous ways, but it has nothing to do with fat storage.  Numerous studies have shown that throughout time, from our ancient ancestors through today, the amount of physical exercise we get has actually not varied that much.  Also interestingly, if you compare children with structured physical education classes, with those who receive no physical education, at the end of the study, the exercise they experienced was nearly identical.  Children who do not experience the exercise they need in P.E. classes seek it out on their own by playing.  The calorie hypothesis has also been proven wrong.  You do not burn a fixed amount of calories a day.  Rather, your body adjusts that amount based on what you eat- not on exercise.  Exercise has very little impact on the calories used.  Most of your energy is used to maintain homeostasis, on digestion and other bodily functions, and your body has numerous mechanisms to adjust metabolism based on the food you eat.  Weight gain or loss is almost exclusively the domain of your insulin levels.

The food we eat belongs to one of three macro-nutrients: carbohydrates, protein, or fat.  We need to eat proteins (essential amino acids) and fats (essential fatty acids) to survive, but we do not need to eat any carbohydrates, at all.  Historically speaking, carbohydrate intake was relatively low, and when they were consumed they were always consumed in their natural forms which is with dietary fiber, which passes through the body.  Unfortunately, particularly in modern America, carbs, including sugars like high fructose corn syrup have been added to nearly everything to compensate for removing fat, following Keys' erroneous low-fat recommendation.  The problem with eating carbs like grains, potatoes, and sugars is that they cause an enormous spike in blood glucose (sugar) levels as your body processes the food.  The human body cannot sustain high blood glucose levels or you'll go into a coma.  So your pancreas cranks out insulin to compensate.  The insulin hormone forces your cells to open up and use the glucose for energy, and store the left-overs as fat (starting in your abdominal area via fatty liver).  For someone who is not insulin resistant, that's not a problem, as long as it only happens once in a while.  The problem arises when we eat carbs continuously and frequently.  Eventually your cells are overrun with glucose, and they do not need or want any more.  They are already full of fat stored from the glucose.  Your cells will become "resistant" to the insulin.  Since your body can't allow the glucose levels to rise too high, or you'll go into a coma, it's imperative that the body get that glucose out of the blood stream, and so the pancreas cranks out more and more insulin until your cells are basically forced to take in more and more glucose and store even more fat.  Think of insulin resistance as someone trying to yell commands over increasingly loud background noise.  They have to get louder and louder to be heard by producing more and more insulin.  Pre-diabetes is when, despite your increased insulin levels, your body is having a hard time convincing your cells to keep storing more fat and so your blood glucose level rises higher and higher.  Eventually, this turns into type 2 diabetes when your body can no longer produce enough insulin to get rid of all the glucose floating around.  That's usually where doctors intervene.  Unfortunately, the majority of doctors do not understand this phenomena and rather than telling the patient to dramatically reduce their carbohydrate intake, which would fix the problem at the source, they treat the symptom by doing the worst thing they could possibly do - they add more insulin.  Your cells are screaming no more glucose, and the doctors are injecting insulin which is forcing the cells to take in more glucose and store even more fat.  This is insane.

There are multiple factors which have led to this situation which most Americans find themselves in:

• The government recommendation to eat a low fat diet has resulted in eating far more carbohydrates, including sugars, because the fat must be replaced by another macro-nutrient, and since protein is expensive, carbs are added.
• Carbs have been made cheaper by government subsidies on corn, wheat, soybeans, and rice, leading to the creation of things like high fructose corn syrup, which is a cheap and pervasive sugar substitute.  This is also why the poorest Americans are also the most obese.  Thanks to government intervention, the cheapest foods are the worst for our health.
• Extensive processing of foods has meant that foods like fruits and vegetables are often not consumed in their natural forms, but only in juices and oils that strip their fiber away, resulting in far higher glucose levels.
• Meal frequency is a huge factor.  Frequent eating is very unhealthy for your body - especially when carbs are involved.  It decreases digestive efficiency and ensures that your body is constantly producing insulin to process the glucose.  This results in a lack of equilibrium.  There is no 'quiet time' where insulin levels can be low to balance out the times when it was high, resulting in your cells getting used to higher and higher constant levels of insulin, causing the insulin resistance.  In the 1950s, Americans typically ate 3 meals a day and they were at fixed times during the day - not late at night.  Today we're up to 6 meals a day, or even more.

Let's contrast the high carbohydrate insanity with someone who eats a low carbohydrate diet, that our ancestors ate for millennia without issue.  Carbohydrates, as we've learned, drive insulin production, which actually drives hunger.  It creates a roller coaster of eating high-carb meals that usually only satisfies your hunger for a couple of hours, if that.  When you reduce your carbohydrate intake to relatively low levels, i.e. less than 30 carbs per day, after a period of adjustment, your hunger melts away.  Protein, and particularly fats are far more filling than carbs, and they last many times longer than carbs.  Not only that, but after a period of days to weeks, depending on how insulin resistant you are, as long as you keep your carb intake low (no cheating) your body will start a process called ketosis which is an extremely satisfying state where your body switches back to it's natural primary fuel - ketones.  Ketones are your body's preferred fuel, which are far more efficient than glucose and are required by your brain to function properly, especially as you age.  Ketones are generated by burning fat - either fat that you consume, or fat that you have stored.  What little glucose your body needs, it generates automatically in a process called gluconeogenesis.  When you're in ketosis, your hunger dramatically dissipates, allowing most people to reduce their meals down to two, or one meal per day.  This gives your body a very long time with low insulin levels, to help to repair the insulin resistance damage that has been done when you were eating the Standard American Diet.  Some people fast for days and that has an extremely beneficial effect on lowering your insulin levels.  Those on a low carb diet tend to eat much higher quality food, like beef, chicken, fish, eggs, butter, cheese, cream, nuts, bacon, cottage cheese, whole fat yogurt, and high fiber vegetables.  This is the natural human diet.

The root of many modern American diseases including heart disease, Alzheimer disease, and even cancer, to one degree or another, is inflammation.  Inflammation is your body's response to attack.  A high carb diet, as we discussed, creates high glucose levels in the blood.  High glucose levels in the blood destroy the endothelial glycocalyx, which are tiny hairs that line the blood vessels and protect the arterial walls from damage by particles moving in the blood stream.  Without this protection, arteriosclerosis occurs as well as coronary artery calcification, which is what causes the blockages in the heart which contribute to heart attacks.  When inflammation damage occurs to arterial walls, the body sends cholesterol to repair them.  Cholesterol, in addition to being essential to moving nutrients around the body, is a firefighter to help to repair damage from inflammation.  This is how cholesterol was unfairly blamed to be a culprit- it was merely found at the scene of the inflammation.  Now we know that cholesterol is not a bad guy at all, but is actually essential to many functions in your body, including brain function.  Statin drugs that reduce cholesterol are doing immense damage to millions of Americans, including raising glucose levels- which creates a vicious cycle of damage to your arteries, as well as causing liver damage, muscle damage, and interfering with delivery of fuel to the brain.  We also know that a low carb diet improves the balance of your cholesterol by reducing triglycerides, increasing HDL cholesterol, and converting LDL cholesterol from Pattern B small particles into Pattern A large particles.

If you want to reverse or avoid insulin resistance, here are some tips to get started.  First,  start tracking everything you eat.  There are various free apps to help with this.  Carb Manager is the one that I use.  It lets you scan bar-codes, or type in items and tracks how many net carbs, as well as proteins and fats that are in what you're eating.  Net carbs are the carbs left over after you subtract dietary fiber from total carbohydrates - both of which can be found on food labels.  If you're a typical American carb-a-holic you need to start by limiting your carbs to something reasonable like 75 net carbs per day, do that for a week, then reduce it to 50 net carbs per day for a week, and finally down to 30 net carbs per day.  30 net carbs per day is usually low enough to get most people in ketosis, but remember that i can take up to 2-3 weeks to get into ketosis once you're down to 30 net carbs per day, and if you cheat just once, you've reset the clock.  Cutting carbs is not hard as long as you are aware of what you eat.  The thing to remember is when you're hungry, eat fat, not carbs.  Fat is much healthier and more filling than carbs.  Some great healthy fats include butter, cream, dark chocolate, eggs, nuts, coconut oil, olive oil, and full-fat yogurt.  Avoid low fat foods.  Eat moderate protein such as beef, lamb, chicken, turkey, pork, jerky, eggs, salmon, trout, sardines, etc.  You can also eat non-starchy vegetables like spinach, peppers, lettuce, green beans, tomatoes, squash, mushrooms, cucumber, asparagus, artichoke, celery, cabbage, broccoli, etc.  You should avoid high sugar fruits, but you can eat low sugar fruits in moderation like avacado, kiwi, cantaloupe, lemon, lime, olives, strawberries, blackberries, raspberries, etc.  If you bake you should use almond flour or coconut flour.  You can drink tea, coffee, water, and diet soft drinks (though many aren't great for you for other reasons - but they are acceptable from an insulin perspective).  If you use artificial sweeteners, be sure they are zero on the glycemic index, such as stevia, splenda, aspartame, etc. and ideally are liquid based, as the maltodextrin in granular sugar substitutes contains carbs. Condiments such as mustard, vinegar, hot sauce, salsa, are typically fine just be careful to read labels if you use Ketchup, BBQ sauce, or salad dressings, as some are loaded with sugar and thus quite carby.

I hope this information has been helpful.  Myself, my wife, and my friends have reversed their insulin resistance, lost weight, and feel so much better on this journey.  All Americans need to learn this extremely valuable information, so please share it.  Some resources I recommend include books and videos by Dr. Ken Berry, Dr. Jason Fung, Dr. Sarah Hallberg, and many others.  If you are already a diabetic and taking medication, you should consult with your doctor to reduce your carb intake and reverse your diabetes.  If your doctor only wants to keep you medicated and pumped full of insulin, you need to find a new doctor.

Please like, subscribe, and share.  I've included links to some excellent videos and books below.

Dr. Sarah Hallberg TEDx Talk https://www.youtube.com/watch?v=da1vvigy5tQ
Butter Makes Your Pants Fall Off https://www.youtube.com/watch?v=h6aMN6NLOTQ
What is Metabolic Syndrome https://www.youtube.com/watch?v=skJDRSRa9w4
The Obesity Code by Dr. Jason Fung https://amzn.to/2KvFoOL
Keto Clarity by Jimmy Moore and Dr. Eric Westman  https://amzn.to/2H0lQ2A