Gijs Heerkens over obesitas (en andere ziekten gerelateerd aan insulineresistentie)

Ingediend door Ivan Janssens op di, 06/07/2021 - 17:04

Interessant en kort artikel dat een mooie aanvulling vormt op mijn artikel over obesitas. De auteur beschrijft obesitas als het gevolg van "energy toxicity" (op zijn beurt het gevolg van de toxische omgeving van energierijk maar nutriënten-arm voedsel): het lichaam krijgt te maken met een overdaad aan energie waarmee het niet mee om kan. Uiteindelijk leidt dit tot een soort van stellingenoorlog tussen insulineresistentie en overgewicht waarbij beiden mekaar versterken. De auteur beschrijft dit proces op uitstekende manier. Het artikel geeft ook een handig overzicht van de verschillende manier waarmee het lichaam omgaat met zijn twee voornaamste bronnen van energie: glucose (koolhydraten) en vetten. Ten slotte zijn er enkel voorstellen van oplossingen die de mijne grotendeels overlappen (het belang van voeldoende slaap had in mijn artikel misschien beter mogen benadrukt worden - dat is alvast gepland voor versie 2.0.).

Energy toxicity 🍪

We are facing an epidemic of chronic disease, mainly associated to excess energy in the body causing chronically high insulin levels. This is called insulin resistance, hyperinsulinemia, pre-diabetes, metabolic syndrome or energy toxicity.

The list of modern chronic ailments is long and scary, but here they are:

  • Alzheimer’s disease
  • Asthma
  • Osteoarthritis
  • Rheumatoid arthritis
  • Cancer
  • Depression
  • Type 2 diabetes
  • Fatty liver
  • Acid reflux
  • Fibromyalgia
  • Gout
  • Sleep apnea
  • High blood pressure
  • Osteoporosis
  • Stroke
  • Coronary artery disease
  • Atherosclerosis
  • Heart failure
  • Erectile dysfunction
  • Polycystic ovarian syndrome
  • Acne
  • Low testosterone
  • Enlarged prostate
  • Gynecomastia
  • Baldness
  • Psoriasis
  • Lupus
  • Peripheral neuropathy
  • Glaucoma
  • Near-sightedness
  • Vertigo
  • Tinnitus
  • Inflammatory bowel disease
  • Sarcopenia
  • Tendinitis
  • Carpal tunnel syndrome
  • Hearing loss
  • Macular degeneration

A whopping 80% of adults have one or more of these listed ailments. Actually, only 12% doesn’t have any signs of insulin resistance and is metabolically healthy. Although these numbers are from the United States, we can take them as a proxy for the rest of the world.

This list comes from a book I just read, The P:E Diet by Ted Naiman, which should be a staple for everyone who wants to understand how our metabolism works and what you can do to avoid problems.

How our metabolism works

There are three macronutrients in foods. Proteins are the building blocks for our bodies and carbohydrates and fats are the energy sources. We can store energy in two ways, that both work completely different:

  1. Carbohydrates are broken down into glucose and fructose that generate energy. All of the energy that’s not used is converted into glycogen and stored in the liver and muscles.
  2. Fats are broken down into fatty acids that generate energy. All of the energy that’s not used is converted into triglycerides and stored in fat cells.

The body can convert glycogen (energy source 1) six times faster than triglycerides (energy source 2), but glycogen is six times heavier to store than triglycerides, because it comes with a lot of water. That’s why the body prefers to store triglycerides over glycogen.

The body always first uses the glycogen in your blood for fuel, and after that the glycogen in your liver, but you are only able to store about 100 grams in total there. After that, you get in the fasted state which means your body starts using body fat for fuel until you eat carbohydrates again.

When you eat carbohydrates all day, like most of us, you will never get in the fasted state and never burn body fat.

For evolutionary reasons you always have to have glycogen around for emergency use. You are also able to store about 300 grams of glycogen in your muscles for that, and that’s only being used when your heart rate is very high. Back in the days this was to flee for a tiger, nowadays it’s high intensity exercise such as sprinting, climbing stairs and weight lifting. You can do around 90 minutes of high intensity exercise to deplete the glycogen stored in your muscles.

The average person does 0 minutes of high intensity exercise a day.

When it gets too much

So our bodies basically are brilliant machines. Then how can it be that so many people (88%!) are not metabolically healthy?

Because we are overfilling our energy storage capacity, eating high energy (carbohydrates and fats) and low nutrition (proteins and minerals) things. Fat cells can expand dramatically in size, but they have a limit. As they fill up more and more with fat, they start refusing to store glucose and triglycerides.

If you continue to eat in an energy surplus at that point, you’ll have a problem. Insulin will attempt to signal cells to take up more energy but the cells are already full, which results in high insulin all the time and overflowing energy stores.

When your fat cells have reached their maximum size, and you have exceeded your genetical capacity for growing new cells, excess energy is being stored into your visceral fat. Your waist circumference is a good proxy for this and should always be maximum 0,5 times your body length (mine is 0,41 at the moment).

The more visceral fat you gain, the more insulin resistant you get. Eventually even these visceral fat cells fill up entirely and then your body starts storing fat anywhere it can, including your organs and blood vessels. This is when you have reached your personal fat limit, which is how fat you are capable of getting.

Exceeding this point results in type 2 diabetes, which is the end stage of insulin resistance. In the process to get to this point you are probably slowly developing several of the listed ailments above.

Every single person has the ability to grow new fat cells and get fatter prior to developing insulin resistance, to a certain extent. Some people are capable of gaining hundreds of kilos before becoming insulin resistant, others have a low fat threshold. This is a dangerous situation, because you can’t judge from the outside.

What you can do to avoid problems

Type 2 diabetes is the end stage of insulin resistance, which is the end stage of being overfat. Along this entire spectrum, the primary problem is storing too much energy in your body, caused by one thing: eating too much energy.

This situation is entirely preventable by doing four things:

  1. Eat whole foods, for example (organ) meat, poultry, eggs, fish, vegetables, avocado, berries and cheese. These foods are nutrient and protein dense. This will make you feel more satiated, which makes it nearly impossible to overeat.
  2. Fast intermittently, for example eat only in an 8 hour eating window and fast for the other 16 hours, every day. This will make you reach the fasted stage (burning body fat) earlier, automatically eat less because of satiety, and helps your body to recover because it’s not processing food all the time.
  3. Practice high intensity exercise, for example cycling, sprinting and weight lifting. These exercises raise your heart rate maximally and will deplete the glycogen in your muscles. It will cost energy to replete the glycogen again. The extra advantage of weight lifting is that the more muscle you have, the more energy your body is using which makes it way harder to get in an energy surplus.
  4. Sleep enough, that is 7 to 8 hours or more every night, 9 is even better. The best way to achieve this is developing a rhythm by going to bed and waking up at the same time all days of the week.